title: The United States' Federal Parity Act and treatment of substance use disorders: Administrators' familiarity and perceptions of impact.
abstract: The 2008 Wellstone and Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) aims to secure parity in private insurance coverage between behavioral and other medical disorders in the United States (U.S.). This legislation represents an important change in the operating field of substance use disorder treatment, but to date, its impact on treatment centers has not been widely examined. The current study measured the extent of center leaders' familiarity with the MHPAEA and their perceptions of its overall impact on their centers.
  
  
  
  Using a nationally representative sample of treatment centers in the U.S., we examined the extent of MHPAEA familiarity and its perceived impact as reported by treatment center leaders. We further employed logistic and ordered logistic regressions to determine personal and organizational characteristics associated with their reported familiarity and experienced impacts, including changes in the number of privately-insured clients seeking treatment and in the treatment coverage of those clients.
  
  
  
  We found that dissemination of parity information was low. Only 36% of administrators reported high levels of familiarity and 16% used professional sources of information. The majority of administrators (71%) reported no impact of the legislation on their organization, but those that reported any impact were more likely to state positive impact. Greater parity knowledge and perceived positive impacts were associated with administrator and organizational characteristics indicative of greater access to industry-specific knowledge, a medical model orientation, and reliance on private insurance revenue.
  
  
  
  This study demonstrates that dissemination of parity information is lacking and that the majority of leaders have yet to experience an impact of the MHPAEA. Leaders of centers with more sophisticated structures are most likely to be familiar with the legislation and perceive a positive impact. Research concerning the effective management of treatment centers, including environmental scanning techniques, continues to be needed.
authors.affiliation: Owens Institute for Behavioral Research, University of Georgia, Barrow Hall, Athens, GA 30602, United States. Electronic address: medmond@uga.edu.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Edmond
authors.affiliation: Owens Institute for Behavioral Research, University of Georgia, Barrow Hall, Athens, GA 30602, United States.
authors.forename: Lydia
authors.initials: L
authors.lastname: Aletraris
authors.affiliation: Owens Institute for Behavioral Research, University of Georgia, Barrow Hall, Athens, GA 30602, United States.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Roman
authors.affiliation: Owens Institute for Behavioral Research, University of Georgia, Barrow Hall, Athens, GA 30602, United States.
authors.forename: Dail L
authors.initials: DL
authors.lastname: Fields
authors.affiliation: School of Social Work, Georgia State University, Urban Life Building, Suite 1243, Atlanta, GA 30303, United States.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Bride
mesh_terms: D006801:Humans; D033181:Information Dissemination; D007342:Insurance Benefits / Q000191:economics / Q000331:legislation & jurisprudence; D019458:Insurance Coverage / Q000191:economics / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D016015:Logistic Models; D016320:Substance Abuse Treatment Centers / Q000191:economics / Q000331:legislation & jurisprudence*; D019966:Substance-Related Disorders / Q000191:economics / Q000628:therapy*; D014481:United States
keywords: Parity legislation; Private insurance; SUD treatment