A Milliman Research Report found that people seeking mental health and substance abuse treatment are more likely to have to use out-of-network doctors, according to The Washington Post.
The report, published by Milliman for the Bowman Family Foundation, a risk management and healthcare consulting company, found disturbing healthcare trends when it analyzed the claims of 37 million people with commercial organization’s health insurance plans from across the country from 2013 to 2017.
Despite Congress passing several bills over the last two decades that were supposed to increase and make access equal to mental and physical healthcare, people looking for inpatient care for behavioral health issues were 5.2 times more likely to have to use an out-of-network provider, the report found.
People looking for substance abuse treatment are 10 times more likely to have to go out-of-network, up from 4.7 times in 2013.
“I thought maybe we would have seen some progress here. It’s very depressing to see that it’s actually gotten worse,” Henry Harbin, former chief executive of Magellan Health, told the Post. “Employers and insurance plans need to quadruple their efforts.”
Children also are seeing less coverage in their networks, the Post reported. Milliman found that in 2017, children were 10 times more likely to have to use an out-of-network provider for a behavioral health office visit than for a regular doctor’s appointment.
But some lawyers don’t believe insurance companies will be incentivized to increase coverage to mental and substance abuse health needs without some form of punishment.
“Without substantial fines against insurers, nothing is going to change because there’s no incentive to change,” Meiram Bendat, a mental health lawyer, told the Post.