Patient Survey Shows Pervasive Disparities in Access for Behavioral Versus Physical Health Care

An HR Policy-supported patient experience survey demonstrates significant access issues for patients seeking mental health and substance use services, underscoring the need for action from all stakeholders. The report, conducted by the National Opinion Research Center, titled Equitable Access to Mental Health and Substance Use Care: An Urgent Need, was released by the Bowman Family Foundation with HR Policy Association listed as a supporter of the report and its recommendations. 

The patient experience survey is consistent with at least five other studies examining network access. These studies range from patient and provider surveys to analyses of insurance claims data and all have found that in-network coverage for the treatment of mental health and substance use disorders is not equal to the coverage for physical health treatment. Some of the key findings of the survey include:

• Over half of patients (57%) reported they were unable to access care for mental health and substance use services on at least one occasion between January 2019 and April 2022.
  
  
• Of patients in employer-sponsored health plans, 39% reported using at least one out-of-network provider for mental health or substance use care, compared to just 15% for physical health care.
  
  
• 80% of patients in employer-sponsored health plans who received outpatient care from an out-of-network provider said they went out-of-network “all of the time” compared to just 6% of patients who said the same for physical health.
  
  
• 98% of adolescent patients who received behavioral health care from primary care physicians or other physical health providers felt they needed additional support from a mental health or substance use specialist.

The report includes recommendations for all stakeholders—payers, providers, regulators, and legislators. The recommendations include:

• Expand mental health and substance use networks by adding appropriately credentialed behavioral health providers of all levels;
  
  
• Integrate mental health services into primary care using clinically effective methods such as the HR Policy-supported Collaborative Care Model and Primary Care Behavioral Health Model so that primary care providers are adequately trained and work in conjunction with a behavioral health care team;
  
  
• Cover and pay for video and audio-only mental health services; and

Comply with federal and state parity laws and urge DOL, HHS, and Treasury to issue additional guidance on parity compliance, as described in a separate story.