• Yona Remer

Mental Health Access

According to a poll conducted by the Kaiser Family Foundation, 52% of Californians believe

their communities lack adequate access to mental health care with 24% of the respondents

claiming to have searched for mental health therapy within the year. This staggeringly high rate of inadequate access is confounding enough, but when measured against nearly a decade of improving rates of insurance access the issue becomes more perplexing.

Theoretically, since the passing of the Affordable Care Act in 2010 and the Mental Health Parity Act in 1996, American’s with private insurance should be entitled to access to mental health care commensurate with their medical care. However, if you’ve ever searched for therapy for yourself or a loved one, you’ll know how challenging and costly the process can be.

Research that assesses in-network versus out-of-network usage rates paints a portrait of just how challenging it can be to find adequate mental health care and how insufficient existing in- network resources are.

The Milliman consulting group recently published a quantitative analysis on the implementation

of the Mental Health Parity Act and found that:

- Out-of-network Behavioral health visits occurred at nearly 5 times the frequency of

general outpatient out-of-network physician visits.

- This disparity is among the highest in California, where out-of-network mental health

usage is 5-10 times as high as it is in primary care settings.

- Behavioral health providers are often reimbursed by insurance companies at roughly 5-

7% below the medicare rate, compared with 15% above the medicare rate for primary

care providers.

With this quantitative research in mind, the reasons for a growing need for mental health and

the lack of therapy options point almost exclusively to insurance and their reimbursement

models. If insurance is not willing to adequately reimburse mental health clinicians for their

services, there’s likely to be a high scarcity of therapy.

This troubling research looks even more bleak when coupled with the higher costs mental

health clinicians face in California-- where housing, cost of living and not to mention student

debt are some of the highest in the nation. When taken together with the cost of premium office space, liability insurance and administrative overhead, it is no wonder mental health providers are more likely to ask clients for $200 upfront before guiding them back to their insurance for reimbursement.

Hubpsych was founded in large part to make this disparity more manageable for clients in need. Our unique and highly customized search process, enables us to help you find the care

providers best fitting to your presenting needs. Our commitment to finding care options at a

range of prices and an optional and affordable reimbursement service, ensures that we can

drastically bring down the cost of seeing an out of network provider and make your insurance

work for you.

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