Behavioral Health Providers: Out-of-Network and Underpaid

In a new study by RTI International, patients were 3.5 times more likely to go out-of-network to see a behavioral health clinician than a medical/surgical clinician in 2021. The study also revealed that reimbursement for in-network office visits to behavioral clinicians was lower compared to medical/surgical clinicians, which may have created disincentives for behavioral health providers to participate in-network.

Additionally, for certain behavioral health visits, patients were up to 20 times more likely to choose an out-of-network provider. For example, patients were 8.9 times more likely to see a psychiatrist, 10.6 times more likely to see a psychologist, 6.2 times more likely for acute behavioral inpatient care, and 19.9 times more likely for sub-acute behavioral inpatient care.

The authors of the study recommend that health plans and states consider increasing reimbursement rates to attract more behavioral health providers to their networks and evaluate reimbursement disparities to address parity violations, as narrower networks can limit access to behavioral health services and increase financial burdens on patients. Overall, the study highlights the importance of improving access to behavioral health services by addressing reimbursement discrepancies and expanding network options for patients seeking mental health care.