Health Insurers are Pushing Therapists Out of Their Networks, Hurting Consumer Access
By Consumers for Quality Care, on September 18, 2024
Despite laws that require insurers to cover care and treatment for mental health just as they would for any other condition, more than 500 therapists interviewed by ProPublica report that insurance companies are making it increasing difficult for them to administer care for patients in need.
Melissa Todd, a psychologist from Eugene, Oregon, had a major health insurer question a patient’s treatment. Todd was treating a young woman who had experienced recent trauma and fit the diagnosis for someone with bipolar disorder. Todd sought a psychiatrist to help manage the patient, but despite searching for months, she couldn’t find an available psychiatrist within her insurer’s network, under UnitedHealthcare. Her client had to pay hundreds of dollars to see an out-of-network psychiatrist. Then, after months of successful treatment, UnitedHealthcare began questioning Todd about whether the care was still needed, asking for a specific date when treatment would end. As a result, Todd decided to leave UnitedHealthcare. Though that particular patient can afford to pay out-of-pocket to see Todd, not all consumers have the financial means to do this.
Low insurance reimbursement rates, delayed payments, burdensome paperwork required by insurance companies, and other bureaucratic red tape are some of the reasons that many therapists leave the workforce altogether. It’s widening an already huge gulf between the demand for therapy and the capacity of the mental-health workforce to provide it. For these reasons, nearly half of Americans seeking mental health services are unable to access care.
When insurers place barriers on mental health professionals, it hurts consumers attempting to access care. CQC calls on insurers to remove red tape that makes accessing and providing mental health services needlessly difficult. CQC also urges lawmakers and regulators to require insurers to ensure these services are available and covered for those who need it.
