Insured Americans face widespread access gaps to mental health and substance use care relative to physical health services, according to the Mental Health Parity Index.
Enrollees in plans offered by the nation’s four largest commercial health insurance companies in 43 states experience potential disparities in finding in-network mental healthcare and substance-use disorder treatment relative to physical healthcare. Locally, seven in 10 counties face similar issues, potentially making it harder for patients to find in-network mental healthcare or substance-use disorder treatment where they live.
“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,” said Dr. Bobby Mukkamala, president of the American Medical Association. “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. These data highlight where payers and policymakers can work together on concrete solutions so patients can get the care they need and overall care quality can improve.”
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The index also revealed that:
- All states show disparities in payment for treatment of mental health and substance-use disorders.
- Across the four national commercial insurance plans assessed, clinicians who provide mental healthcare and substance-use disorder treatment are paid between 16% and 59% differently from physical health clinicians.
- On average, the four national insurance plans provide in-network access that is from 24% to 83% different for physical health clinicians relative to those available in-network for mental healthcare and substance-use disorder treatment.
Although no insurance company achieves comparable parity metrics nationwide, some commercial networks were found to meet or exceed parity metrics in select states or counties. Addressing potential access and pay gaps tackles one of the biggest issues facing care, which should be paired with steps toward improving the quality of the care to which people have access, the report said. It can also highlight best practices among insurers that can be shared more widely.
“As a psychologist, I’ve seen how easily well-being falls to the bottom of our to-do lists, but I’ve also seen how systemic barriers can make care feel out of reach,” said Michelle Quist Ryder, PhD, CEO of the American Psychological Foundation. “Looking at real insurer data reveals a deeply concerning issue—widespread gaps in coverage that affect both the people seeking care and the clinicians striving to provide it.
“Transparency is a powerful first step in advancing parity across the nation while at the same time empowering providers and consumers to demand accountability. We must build a system that truly prioritizes mental health as essential health care, not simply an optional benefit.”
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