NETWORK ADEQUACY
The resources below relate to network adequacy, i.e., ensuring access to in-network MH/SU providers:
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Insurance Claims Data Analyses of Disparities:
Press Release – New Study Finds Continuing Pervasive Disparities in Access to In-Network Mental Health and Substance Use Disorder Treatment
List of Supporting Organizations and Quotes
RTI International Website
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2019 Updated and Expanded Milliman Disparities Research Report, entitled: Addiction and mental health vs. physical health: Widening disparities in network use and reimbursement; A deeper analytical dive and updated results through 2017 for 37 million employees and dependents
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2018 Differential Reimbursement of Psychiatric Services by Psychiatrists and Other Medical Providers by authors at RTI, Truven, and SAMHSA
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2020 Milliman High-Cost Report – Impact of behavioral health conditions on physical and total healthcare spending
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Mental Health Access and Parity Recommendations for Plan Sponsors – actions an employer can take to address in-network access to MH/SU care and parity compliance
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2023 Model Data Request Form (MDRF) (Updated) – Quantitative data templates used by employers, employer coalitions, regulators and other stakeholders in requesting targeted, quantitative data from third party administrators and insurers for assessment of access to in-network behavioral health services. The MDRF has been used as a source and template by multiple regulators. Note: Clicking this link will download a Word document to your computer, which contains embedded Excel files.
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Data from Surveys Regarding Access to MH/SU Care:
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Surveys of Patients and Providers:
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2023 Survey conducted by NORC – Equitable Access to Mental Health and Substance Use Care: An Urgent Need: Patient-experience survey conducted by NORC shows stark access barriers for mental health versus physical health and reviews several related studies by others
Press Release – New Patient Survey Shows Pervasive Disparities in Access Between Mental Health and Substance Use Versus Physical Health Care: Leading mental health and employer groups come together around health system solutions for the nation's "staggering public health challenge" in mental health
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Network Access and Adequacy – Summary of Published and Unpublished Research 2018-2023 of Susan H. Busch and Kelly A. Kyanko
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2022 Template Survey of Employees to Evaluate Access to In-Network MH/SU Care – A survey employers can use to learn about their employees' experiences seeking MH/SU care
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Surveys of Employers:
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2023 Voice of the Purchaser – Survey of 220 employers by the National Alliance of Healthcare Purchaser Coalitions and the HR Policy Association
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2022 Kaiser Family Foundation – Survey of 2,188 employers
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