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How Payers Are Increasing Access to Behavioral, Mental Healthcare Services

Payers are working toward achieving broader access to mental healthcare and behavioral healthcare services by reimbursing at higher rates and supporting primary care.

Payers are offering providers and consumers a broad range of services and supports related to mental healthcare and are taking steps to increase access to mental healthcare, according to a survey conducted by AHIP.

The survey asked participants 14 questions in May and June 2022. Participants were individual market and group health plans representing a total of 95 million lives.

The in-network behavioral healthcare provider population has grown by 48 percent in the past three years, payers indicated. Specifically, the applied behavioral analysis specialist field has expanded substantially (135 percent). Psychiatric nurse providers also saw strong growth in three years, increasing by 87 percent. 

Providing access to mental healthcare seemed to be a priority for many payers. Every health plan participant offered telebehavioral healthcare services, and most were engaged in actively recruiting mental healthcare providers (89 percent). 

Most payers affirmed two recruitment goals: pursuing healthcare workforce diversity and reimbursing mental healthcare at higher rates. 

“Health insurance providers report increasing reimbursement rates for contracted behavioral health providers to attract high quality professionals for mental health support,” the report stated.

Nearly eight in ten health plans had boosted behavioral healthcare workers’ reimbursement rates (78 percent). Additionally, 83 percent of payers had attracted and retained a diverse population of behavioral healthcare providers.

Substance abuse care is becoming more accessible, the survey found. Specifically, more providers have become eligible to offer medication-assisted therapy (MAT). This population has expended 114 percent over the course of three years.

Nearly three-quarters of health plans (72 percent) support behavioral healthcare training for primary care providers. The same share supported primary care providers by helping them find behavioral healthcare specialist referral partners.

Payers have also offered primary care providers the opportunity to call behavioral healthcare specialists via telehealth or telephone in order to consult them on a patient’s condition. More than half of the health plans (56 percent) provide this option. This method has been used in pediatric psychiatry to solve members’ challenges in connecting with specialists.

Health plans reported a couple of main ways that they try to connect members with mental healthcare services. Many plans do this by supporting patient navigation (83 percent). For example, health plans might connect members with community-based organizations that can address their social determinants of health needs. 

Additionally, more than eight in ten health plans said they help members secure behavioral healthcare visits. Follow-up on inpatient care and emergency room visits is often part of health plans’ efforts to connect members with mental health services as well. Seventy-eight percent of the plans leveraged specialized case managers to perform this function.

These efforts are timely since mental and behavioral healthcare access is clearly in demand among consumers.

Americans say that health insurers are responsible for covering their mental healthcare services and many attest that their health plans are covering some or all of those costs, according to a separate survey. Six out of ten insured Americans reported that their mental healthcare needs were fully covered and around three in ten said that these services were partially covered.

CVS Health found that more Americans value conversations about mental health within their communities and workplaces.

These trends may be partially due to the ways that the coronavirus pandemic exposed and heightened the need for access to mental and behavioral healthcare services.

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