31% of Health Plan Purchasers Dissatisfied with Behavioral Health Network Effectiveness

New survey data reveals broad dissatisfaction among health plan purchasers over behavioral health network access quality.

The survey finds near universal acknowledgment (99%) that timely access to in-network behavioral health is important. However, only 31% of health plan purchasers were satisfied with the effectiveness and timeliness of behavioral health provider networks.

The survey was conducted by the National Alliance of Healthcare Purchaser Coalitions and HR Policy Association and paid for by Path Forward for Mental Health and Substance Use, according to a news release.

“Many of the services provided, particularly in managing network access, continue to fall short of employer expectations,” Michael Thompson, the CEO and president of the National Alliance of Healthcare Purchaser Coalitions, said in the release. “While there are bright spots, as an industry we still have a long way to go to meet the needs of employees and their families.”

Regarding accessibility, 31% of respondents expressed either outright dissatisfaction or some dissatisfaction while 43% expressed that they were somewhat satisfied.

The National Alliance of Healthcare Purchaser Coalition finds that many issues identified in a 2018 report remain, marking slow progress in improving access to behavioral health resources for employers and other health plan purchasers.

“While some progress is evident, many of the issues we cited in 2018 have persisted and we must double down on industry commitment and accountability to address these issues moving forward,” Thompson said.

The survey fielded responses from 221 private and public employers, with over 10 million lives covered in the U.S. The two largest respondent groups were companies with more than 10,000 employees (34%) and those with between 1,000 and 4,999 (25%). About 62% of the respondents operate in the health care and social assistance, government, manufacturing or other segments of the economy.

Health plan purchasers have significant interest in access to behavioral health services via telehealth: 95% said telehealth services were important, while 65% expressed satisfaction with their services. Nearly all health plan purchasers reported telehealth significantly improving access to behavioral health services.

“Virtual care has been a great improvement in access to care, but in-person remains an important mode of treatment and is far less accessible both from an availability and in-network standpoint,” an unnamed respondent said in the survey report.

About 95% of respondents said it was important or very important that health plans provide effective access to behavioral telehealth services.

Telehealth use in behavioral health exploded as a result of the pandemic. Pre-pandemic less than 1% of all behavioral health visits were conducted via telehealth. As of the second quarter of 2022, about 33% of all visits in the space were done via telehealth, according to data from Trilliant Health.

Across the whole of telehealth — including other health care segments — 64% of all telehealth visits were for a behavioral health issue, Trillian Health found.

Other concerns include a lack of integration of behavioral health with primary care. Most respondents (84%) say plans should promote integration, but only 28% were satisfied with their plans.

However, 76% of respondents agreed or somewhat agreed that their behavioral health provider directories were accurate.

This opposes the narrative pushed by some federal lawmakers as they seek to push additional regulations meant to increase the accuracy of behavioral health networks. Monikered ghost networks, lawmakers and experts recently testified to network accuracy issues causing problems for patients and providers alike.

Research finds that as many as half of the behavioral health providers in some Oregon Medicaid plan networks didn’t see any patients, an indicator of an issue of that provider being listed in the network in the first place.