Physical healthcare providers are receiving significantly higher payments from insurers than addiction and mental health providers for the same types of services, finds a groundbreaking, independent report published today by Milliman, Inc. and released by a coalition of America’s leading mental health and addiction advocacy organizations. In the Milliman report, commissioned by the Bowman Family Foundation, 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 by consumers is extremely high when compared to physical health care providers.
Milliman researchers used three years of insurer claims data from 2013 to 2015 covering 42 million Americans, and looked at inpatient and outpatient services, primary care office visits, and specialist office visits, comparing in-network and out-of-network claims in all 50 states and D.C. When taken together, the analysis paints a stark picture of restricted access to affordable and much-needed addiction and mental health care in an era of escalating suicide rates and opioid overdose deaths. Further, these disparities point to potential violations of federal and state parity laws, which require insurance companies to treat diseases of the brain, such as clinical depression and opioid addiction, the same way they treat illnesses of the body, such as cancer and heart disease.