Jenny GoldThe Washington Post
Originally published 1 Dec 19
Here is an excerpt:
A report published by Milliman, a risk management and health-care consulting company, found that patients were dramatically more likely to resort to out-of-network providers for mental health and substance abuse treatment than for other conditions. The disparities have grown since Milliman published a similarly grim study two years ago.
The latest study examined the claims data of 37 million individuals with commercial preferred provider organization’s health insurance plans in all 50 states from 2013 to 2017.
Among the findings:
●People seeking inpatient care for behavioral health issues were 5.2 times more likely to be relegated to an out-of-network provider than for medical or surgical care in 2017, up from 2.8 times in 2013.
●For substance abuse treatment, the numbers were even worse: Treatment at an inpatient facility was 10 times more likely to be provided out-of-network — up from 4.7 times in 2013.
●In 2017, a child was 10 times more likely to go out-of-network for a behavioral health office visit than for a primary care office visit.
●Spending for all types of substance abuse treatment was just 0.9 percent of total health-care spending in 2017. Mental health treatment accounted for 2.4 percent of total spending.
In 2017, 70,237 Americans died of drug overdoses, and 47,173 from suicide, according to the Centers for Disease Control and Prevention. In 2018, nearly 20 percent of adults — more than 47 million people — experienced a mental illness, according to the National Alliance on Mental Illness.
“I thought maybe we would have seen some progress here. It’s very depressing to see that it’s actually gotten worse,” said Henry Harbin, former chief executive of Magellan Health, a managed behavioral health-care company, and adviser to the Bowman Family Foundation, which commissioned the report. “Employers and insurance plans need to quadruple their efforts.”
The info is here.
