Executive Summary
Everyone deserves access to effective, affordable, and equitable mental health support and counseling. Health insurance providers, care professionals, and government agencies must work together to set high-quality standards and guidelines in order to ensure patients see measurable results when they get the mental health care and substance use disorder (SUD) care they need.
Health insurance providers support patients by helping them find the services they need at a price they can afford. This includes expanding access to telehealth appointments, integrating mental health support into primary care visits, and working to expand our health care system’s capacity and increase the number of mental health and SUD practitioners in health plan networks. We are committed to working together to improve access to mental health and SUD care for every patient who needs it.
Since the COVID-19 pandemic, more Americans of all ages are seeking mental health care – stretching capacity to its limits. At the direction of our Board of Directors, AHIP engaged our member organizations to evaluate the current state of access for patients, identify current challenges with mental health and SUD care access and delivery, discover innovative approaches to support broader access, identify effective strategies to improve equity, and outline the important role health insurance providers must play in collaboration with many other stakeholders. This vision of the future is paired with specific policy recommendations that health care stakeholders can take, together, to improve access and care for patients.
Our work is based on a comprehensive review of mental and SUD care access challenges facing patients and the system today. The landscape has shifted dramatically since the outset of the pandemic and so must our approaches. Improvements are possible but must involve collaboration with other stakeholders, such as providers.
Our surveys of member organizations, analyses of existing evidence and studies, and numerous discussions with members have resulted in 8 key recommendations:
- Help Patients Navigate to the Right Setting and Practitioner, Based on Their Needs
- Foster Clinical Integration of Mental Health and SUD Care with Primary Care
- Increase Capacity and Workforce While Maintaining Quality
- Leverage High Value, Evidence-Based Technology/Virtual Care/Digital Care
- Build on Private Market Efforts to Achieve Parity
- Address Issues of Equity and the Impact of Non-Clinical Factors, Including Social Determinants of
Health (SDOH) - Work to Improve Quality Performance and Measurement and More Clearly Define Value
- Promote Access to Evidence-Based Substance/Opioid Use Disorder (SUD/OUD) Treatment