APA alarmed by poor network access for mental health patients – APA Psychology News

Washington A new report finding that many mental health patients must go out of network to find care is disturbing and points to the necessity for insurance reform to ensure access to those in need, according to the American Psychological Association.

The findings of this report, while not surprising, are gravely disappointing, said APA CEO Arthur C. Evans Jr., PhD. The federal parity law, the Mental Health Parity and Addiction Equity Act, passed in 2008 and it has still not achieved its goal of equitable access to care for mental health patients. The report also highlights the importance of fully enforcing that law. The fact that so many patients are forced to go out of network to receive mental health and substance use care is unacceptable.

The reportBehavioral Health ParityPervasive Disparities in Access to In-Network Care Continuefound that patients were 10.6 times more likely to go out of network to find psychological care than to find specialty medical care. (High out of network use is a key indicator that a network does not meet patients needs, and that professionals are available beyond the network.) The report also found that lower reimbursement for mental health providers was a major cause of inadequacy for mental health networks. The report stresses this access problem is not due to a shortage of providers, but a shortage of in-network providers.

This situation places an undue financial burden on patients who must shoulder the higher costs of out-of-network care, if their health insurance has out-of-network coverage, Evans said. Patients who do not have out-of-network coverage may need to forgo care if they cannot find in-network providers and cannot afford the full cost of care, thus worsening the existing mental health crisis.

The report highlights the need for insurance plans to improve access to mental health providers to meet patient needs. At the same time, given that existing behavioral health networks are inadequate, APA continues to call for full enforcement of the federal parity law.

The report was conducted by health economists at the nonprofit research institute RTI International. It was commissioned by the Mental Health Treatment and Research Institute, a tax-exempt subsidiary of The Bowman Family Foundation. APA contributed to the cost of the study but had no role in its findings or recommendations.

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APA alarmed by poor network access for mental health patients - APA Psychology News