People with commercial health insurance may still have a harder time getting mental health care than physical health care, according to data from the Mental Health Parity Index, a tool that tracks commercial insurance access and payment patterns.
The index points to access gaps across much of the country. In 43 states, patients face disparities in finding in-network mental health and substance use providers compared with physical health clinicians. At the county level, seven in 10 counties show similar gaps, suggesting that patients may have fewer local in-network options for mental health care.
Payment differences are also widespread. Across all 50 states, clinicians providing mental health and substance use treatment are paid less than those providing physical health care. Nation-wide, the gap ranges from 16% to 59% across the four largest commercial insurance plans analyzed.
The index also found a clear difference in network availability. On average, plans offer 24% to 83% more in-network access to physical health clinicians than to mental health and substance use providers. According to the groups behind the index, that can mean longer wait times, higher out-of-pocket costs, and greater reliance on out-of-network care.
“Mental health parity is about one simple promise: that mental health and addiction care are treated the same as any other medical care,” said Patrick J. Kennedy, co-founder of The Kennedy Forum and co-author of the Mental Health Parity and Addiction Equity Act of 2008.
“The Mental Health Parity Index makes it impossible to ignore where we stand and offers a powerful opportunity to intentionally shape how we track and deliver treatment, building on work The Kennedy Forum has advanced to promote measurement-based care and new payment models that reward quality. This is a breakthrough moment to expand our vision - from what’s necessary to what’s possible - to give people the care they deserve no matter where they live.”
While no insurance company achieved comparable parity metrics nationwide, some plans met or exceeded those metrics in certain states or counties. The index is meant to help insurers, employers, policymakers, and providers see where the biggest gaps are and where improvements may be needed.
The findings also add to the broader discussion over whether insurers are meeting parity requirements in practice.
“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,” said Bobby Mukkamala, MD, president of the American Medical Association.
States are also beginning to use the tool for closer analysis. Illinois has started reviewing its parity landscape following new legislation, while New York plans a similar review of data affecting its commercially insured population.
