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Research Finds Significant Disparities in Access to Mental Health Care

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Authors: Margaret Faso

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An RTI study of one of the largest commercial claims databases demonstrates that out-of-network use of behavioral health providers is significantly higher than that of medical and surgical providers. The independent research suggests that despite efforts to improve access to mental health services, employers and other stakeholders have not yet achieved parity in benefits, impacting the affordability of services for employees.

By the numbers: Patients went out-of-network 3.5 times more often to see a behavioral health clinician than a medical clinician, even for telehealth visits. When trying to see a psychiatrist or psychologist, out-of-network visits were 8.9 times and 10.6 times more likely.

Americans rate system D or F: The RTI findings align with Americans’ experience accessing mental health care, with Gallup finding that 83% rate the U.S. health care system a D or F on its ability to address mental health issues.

Cost is the top barrier for Americans finding mental health providers. Gallup found that affordability and difficulty in finding a provider are the top two barriers to accessing behavioral health treatment. This finding underscores the importance of building robust networks of behavioral health providers.

Employers continue to invest in employee wellbeing. Employers continue to focus on improvements to employee wellbeing and recognize the impact such investments can have on employee engagement and productivity. According to The Conference Board, 95% of CHROs state they will maintain or increase spending on wellbeing initiatives in 2024.

Reimbursement rates are a potential lever. Behavioral health providers argue low reimbursement rates keep them from participating in networks. According to RTI’s research, average reimbursement for medical/surgical office visits was 21.7% higher than for all behavioral health clinicians. Physician assistants are even reimbursed 19% more than psychiatrists, who hold MDs.

Looking ahead: While many efforts to improve access are underway in Congress, particularly around expanding telehealth and integrated models, this research demonstrates the solution won’t be easy. Regulatory efforts to enhance compliance place a significant burden on employers and reinforce the need for all stakeholders to make changes.

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