Addiction and mental health vs. physical health: Analyzing disparities in network use and provider reimbursement rates

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By Stephen P. Melek, Daniel Perlman, Stoddard Davenport | 30 November 2017

As state and federal regulators increase their focus on the enforcement of mental health and addiction parity laws, nonquantitative treatment limitations have emerged as a key trouble area for some health plans. This report provides a quantitative approach to investigating nonquantitative treatment limitations. It focuses on two quantitative analyses: (1) out-of-network utilization rates for inpatient and outpatient facility services as well as professional office visits and (2) reimbursement rates for office visits for in-network healthcare providers. The report includes appendices that provide detailed results for each state, including sample sizes, for 2013 to 2015.

This article was commissioned by Mental Health Treatment and Research Institute LLC, a not-for-profit subsidiary of The Bowman Family Foundation.