Disparities in Network Use and Reimbursement Rates

Milliman, Inc. published an independent report analyzing the disparities in addiction and mental health care versus care for other ailments. Researchers found that along with payment disparities, which occur in 46 out of 50 states, “out-of-network” use of addiction and mental health treatment providers is extremely high when compared to physical health care providers. The report may be found here.

APA CEO and Medical Director Saul Levin, M.D. said the report echoes what the APA has said for several years: insurers are not maintaining adequate networks of psychiatrists for patients, which stems from the fact that they reimburse psychiatrists substantially less than primary care doctors for the same services. The result is an unequal health care system for patients with mental illness or substance use disorders.

The APA signed on to a joint press release calling on state and federal regulators to ensure that insurance companies are abiding by parity laws already on the books.  The MPS sent a copy of the report to officials at the Maryland Insurance Administration with an offer to help address the problems that it identifies.