Access to In-Network Mental Health Care Still Lags Far Behind Other Medical Care

Patients are far more likely to go out of network to obtain health care from mental health professionals than from medical or surgical professionals, areport by RTI International has found.In research that was partially funded by APA, Tami L. Mark, Ph.D., M.B.A., and William J. Parish, Ph.D., M.A., analyzed enrollment data and claims from more than 22 million individuals captured annually from 2019 through 2021 to evaluate out-of-network use and reimbursement rates across all 50 states.The researchers found that patients went out of network 3.5 times more often to see a behavioral health professional (physician or nonphysician) than to see a medical or surgical professional. Patients went out of network 8.9 times more often to see a psychiatrist than another specialty physician, and 6.9 times more often to see a psychiatrist than a primary care physician.The researchers also found that reimbursement for an in-network office visit was 22% higher for medical and surgical professionals than office visits with behavioral health professionals. Notably, physician assistants were reimbursed for office visits an average of 19% higher than psychiatrists, while nurse practitioners were reimbursed about 8% higher than psychiatrists.Mark and colleagues concluded that shortages of behavioral health professionals do not explain the disparities in out-of-network use and reimbursement. “The finding of large disparities for out-of-network use and reimbursement rates highlights that health p...
Source: Psychiatr News - Category: Psychiatry Tags: billing codes health care insurance out of network parity pay disparities reimbursement RTI International Source Type: research