Nationwide, people with commercial insurance are nine times more likely to see a psychiatrist not in their insurer's network than a medical or surgical specialist.
A report from the Research Triangle Institute found across behavioral health provider types, patients were nearly four times as likely to see an out-of-network behavioral provider than an out-of-network medical provider.
The disparities in in-network usage rates were higher for specialists, including psychiatrists, and for acute care.
Out-of-network providers often mean higher out-of-pocket costs for patients. The Research Triangle Institute pointed to low reimbursement rates as the cause of smaller networks for behavioral health, not a shortage of providers.
Here are the 10 states with the largest disparities in in-network utilization for psychiatrists:
- Massachusetts
Out-of-network utilization, medical/surgical specialists: 0.5%
Out-of-network utilization, psychiatrists: 22.8%
Psychiatrist out-of-network utilization compared to medical/surgical: 42.1x greater
- Rhode Island
Out-of-network utilization, medical/surgical specialists: 0.5%
Out-of-network utilization, psychiatrists: 20.4%
Psychiatrist out-of-network utilization compared to medical/surgical: 37.9x greater
- Kentucky
Out-of-network utilization, medical/surgical specialists: 0.2%
Out-of-network utilization, psychiatrists: 6.6%
Psychiatrist out-of-network utilization compared to medical/surgical: 30.6x greater
- Maryland
Out-of-network utilization, medical/surgical specialists: 0.8%
Out-of-network utilization, psychiatrists: 17.3%
Psychiatrist out-of-network utilization compared to medical/surgical: 21.1x greater
- Pennsylvania
Out-of-network utilization, medical/surgical specialists: 0.7%
Out-of-network utilization, psychiatrists: 13.5%
Psychiatrist out-of-network utilization compared to medical/surgical: 18.1x greater
- Louisiana
Out-of-network utilization, medical/surgical specialists: 0.7%
Out-of-network utilization, psychiatrists: 10.9%
Psychiatrist out-of-network utilization compared to medical/surgical: 16.6x greater
- Delaware
Out-of-network utilization, medical/surgical specialists: 0.4%
Out-of-network utilization, psychiatrists: 7.4%
Psychiatrist out-of-network utilization compared to medical/surgical: 16.5x greater
- California
Out-of-network utilization, medical/surgical specialists: 2.2%
Out-of-network utilization, psychiatrists: 34.8%
Psychiatrist out-of-network utilization compared to medical/surgical: 15.9x greater
- Washington
Out-of-network utilization, medical/surgical specialists: 2.3%
Out-of-network utilization, psychiatrists: 36%
Psychiatrist out-of-network utilization compared to medical/surgical: 15.6x greater
- Virginia
Out-of-network utilization, medical/surgical specialists: 0.6%
Out-of-network utilization, psychiatrists: 8.3%
Psychiatrist out-of-network utilization compared to medical/surgical: 13.5x greater