Study: Disparities in access to in-network behavioral health care pervasive

Patients went out-of-network 3.5 times more often to see a behavioral health clinician than a medical/surgical clinician in 2021, and up to 20 times more often for certain behavioral health visits, according to a new study by RTI International. For example, patients went out-of-network 8.9 times more often to see a psychiatrist, 10.6 times more often to see a psychologist, 6.2 times more often for acute behavioral inpatient care, and 19.9 times more often for sub-acute behavioral inpatient care.

Reimbursement for in-network office visits to behavioral clinicians was lower than for medical/surgical clinicians, which the authors suggest created disincentives for behavioral health providers to participate in-network. The authors call for health plans and states to use higher reimbursement to expand their behavioral health networks, and evaluate reimbursement disparities to identify and remedy parity violations, noting that narrower networks reduce access to behavioral health services and increase patients' financial burden.