Gaps in Commercial Insurance Networks

Posted By: Sidney Wild Insurance Updates,

a hand keeps a set of blocks from falling on four wooden figures.

Pictured above: a hand keeps a set of blocks from falling on four wooden figures.

For a lot of Oklahomans, finding access to mental health care can be a struggle. In fact, over half of Oklahomans rely on the health insurance provided through their employer to access care. The team at Healthy Minds Policy Initiative have done research to explore and break down barriers to accessing mental health care provided through commercial insurance. While studying the largest private insurance networks in Oklahoma, they have made discoveries that might be the answer to why it is so difficult for many Oklahomans to get an appointment with a mental health care provider. 

One of the findings from their research, which was conducted from 159 behavioral health providers that were listed by insurance networks, was that only 35% of mental health providers were able to be reached by phone. Of the providers who were able to be reached, only 33% were able to schedule within a month and only 18% were able to schedule within a week. Healthy Minds also discovered that only 30% of behavioral health providers in the state are in network with insurance. Mental health providers cite low pay as reasons to not get in network. In addition, insurance providers offer fewer behavioral health therapists for rural Oklahomans and those with complex needs such as substance use treatment. 

The implications of these gaps result in long wait times for consumers, unreliable information about in-work providers, and higher costs for care. The implications for employers include employees with untreated depression losing an average of 31 days (about 1 month) of lost productivity per employee. To fix these issues, Healthy Minds proposed that more collaboration between providers and insurance companies, employers need to be more aware of the plan they buy for their employees, and health plan networks need to be held accountable for paying providers a fair wage.

A summary of Healthy Minds' research findings can be downloaded here

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