According to a recent study by RTI International, patients are more likely to seek out-of-network care when seeing a behavioral health clinician compared to a medical/surgical clinician. The study found that patients went out-of-network 3.5 times more often for behavioral health visits, and up to 20 times more often for certain behavioral health services.
For instance, patients were 8.9 times more likely to see a psychiatrist out-of-network, 10.6 times more likely to see a psychologist, 6.2 times more likely for acute behavioral inpatient care, and a staggering 19.9 times more likely for sub-acute behavioral inpatient care. This trend suggests that there may be issues with the availability of in-network behavioral health providers and the reimbursement rates for their services.
The study also found that reimbursement for in-network office visits with behavioral clinicians was lower than for medical/surgical clinicians, leading the authors to believe that this could be a disincentive for behavioral health providers to participate in-network. The authors recommend higher reimbursement rates to attract more behavioral health providers to join in-network, as well as a closer evaluation of reimbursement disparities to ensure parity between medical/surgical and behavioral health services.
Overall, the study highlights the importance of expanding behavioral health networks to improve access to care and reduce financial burdens on patients. Narrow networks can limit patient access to behavioral health services, so it is crucial for health plans and states to prioritize the inclusion of behavioral health providers in their networks.