43 states have mental health insurance disparities: 4 trends

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The Mental Health Parity Index found 43 states have disparities in access to in-network mental health care and substance use disorder treatment.

The tool — created by the American Medical Association, the American Psychological Foundation, The Kennedy Forum, Third Horizon and the Ballmer Group —  is an interactive, open-access platform that analyzes payer data to compare access, network participation and reimbursement for mental and physical health services. It was built using CMS’ transparency in coverage data and was piloted in Illinois.

The parity tool found four national disparities, according to an April 14 news release.

1. Patients in about 70% of U.S. counties face challenges finding in-network clinicians for mental health and substance use disorder care, compared to physical health clinicians.

2. All states had disparities in payment for mental health and substance use treatment. Across four national commercial insurance plans, behavioral health clinicians saw a 16% to 59% pay difference in outpatient mental health care compared to outpatient physical healthcare.

3. On average, in-network access had a 24% to 83% difference for physical health clinicians compared to behavioral health colleagues.

4. No insurance company achieves comparable parity metrics nationwide, but some networks met or exceed parity metrics in select states or counties.

“Patients deserve the same access to mental health and substance-use disorder services as they do for any other medical condition — it’s that simple,” AMA President Bobby Mukkamala, MD, said in the release. “Strong federal and state laws require affordable and accessible in-network mental health and substance-use disorder services, but patients still have to fight insurers to get it. The Index demonstrates that many health insurance companies can improve networks for patients and payment for clinicians.”

At the Becker's Fall Behavioral Health Summit, taking place November 4–5 in Chicago, behavioral health leaders and executives will explore strategies for expanding access to care, integrating services, addressing workforce challenges and leveraging innovation to improve outcomes across the behavioral health continuum. Apply for complimentary registration now.

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