政策制定者如何围绕行为健康进行创新:通过新墨西哥州 "无行为健康费用分担 "法

Samantha J. Harris, Ezra Golberstein, Johanna Catherine Maclean, Bradley D Stein, S. Ettner, Brendan Saloner
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摘要

长期以来,国家决策者一直寻求通过保险市场改革改善获得精神健康和物质使用障碍(MH/SUD)治疗的机会。审查具有创新精神的决策者(“政策企业家”)所作的决定,可以了解立法改革的潜在范围和限制。从2022年开始,新墨西哥州成为第一个在受州监管的私人保险计划中取消MH/SUD治疗费用分担的州。基于关键信息提供者访谈(N = 30),本研究叙述了该法律的通过和预期影响。促成该法律通过的主要因素包括:乐于接受的领导、具有医疗和保险背景的立法倡导者、使用当地研究证据、倡导者证词、卫生行业人士的支持、精神健康和物质使用障碍的严重程度,以及在COVID-19大流行期间对MH/SUD的更多关注。研究结果对考虑制定类似法律以改善MH/SUD治疗的国家具有重要意义。
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How Policymakers Innovate Around Behavioral Health: Adoption of the New Mexico “No Behavioral Health Cost-sharing” Law
State policymakers have long sought to improve access to mental health and substance use disorder (MH/SUD) treatment through insurance market reforms. Examining decisions made by innovative policymakers (“policy entrepreneurs”) can inform the potential scope and limits of legislative reform. Beginning in 2022, New Mexico became the first state to eliminate cost-sharing for MH/SUD treatment in private insurance plans subject to state regulation. Based on key informant interviews (N = 30), this study recounts the law’s passage and intended impact. Key facilitators to the law’s passage included receptive leadership, legislative champions with medical and insurance backgrounds, the use of local research evidence, advocate testimony, support from health industry figures, the severity of mental health and substance use disorders, and increased attention to MH/SUD during the COVID-19 pandemic. Findings have important implications for states considering similar laws to improve access to MH/SUD treatment.
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