Mental Healthcare Access and Quality Critical but Lacking per National Alliance of Healthcare Purchaser Coalitions and HR Policy Association Employer Survey
WASHINGTON – April 25, 2023 – Only 31% of employers were satisfied with network access for behavioral health services according to a survey of 221 employers that provide health coverage to over 10 million employees and dependents. The Voice of the Purchaser Survey on Behavioral Health Support was conducted by the National Alliance of Healthcare Purchaser Coalitions and HR Policy Association and funded by the Path Forward for Mental Health and Substance Use.
“Our study found a strong employer consensus on what is critical and significant variation in health plan and vendor performance,” said Michael Thompson, National Alliance president and CEO. “Many of the services provided, particularly in managing network access, continue to fall short of employer expectations. While there are bright spots, as an industry we still have a long way to go to meet the needs of employees and their families.”
Findings were presented today at a Path Forward mental health convening of employers, business health coalitions, mental and behavioral health service providers and health plans, and other industry stakeholders.
Employers were asked to rank the level of importance in specific areas and their satisfaction with their service providers’ performance. Highlights of the findings include:
- Network access
- While 99% agreed that effective and timely access to in-network behavioral health providers is important; 31% expressed dissatisfaction with efforts to identify and address gaps in network access
- Tele-behavioral health was important to 95% of employers and 65% were satisfied around these services
- Only 34% of employers agreed that their behavioral health directories were an accurate reflection of the providers available to plan participants
- Quality of care
- While 54% were satisfied with the promotion of standardized measurement for behavioral health services, only 33% were satisfied with engagement and reporting of behavioral health outcomes
- Integration of behavioral health into primary care
- 84% agreed that it was important that plans support, promote and incentivize integration of behavioral health into primary care, but only 28% were satisfied
- 64% agreed that early identification through broad use of behavioral health screenings can mitigate the severity of mental health issues
- Workplace mental health support
- Achieving high engagement in workplace behavioral health programs was important to 92%, but only 39% were satisfied
- Health equity and whole person health
- Only 27% of employers were satisfied that their service providers evaluate and tailor behavioral health services to diverse communities (e.g., LGBTQ+, People of Color)
- Only 14% of employers were satisfied with service provider support of whole person program integration through data and process coordination
“Supporting the mental health and wellbeing of employees and their families is a top priority for major employers,” said Mark Wilson, vice president of health and employment policy and chief economist for the HR Policy Association. “We need to work collaboratively with all stakeholders, especially our health plan and vendor partners, if we are going to be able to provide timely access to affordable, high-quality behavioral health providers.”
Slow progress in moving the needle
Five years ago the National Alliance released data on how leading health plans and behavioral health organizations delivered mental health services finding disparities for access to behavioral health when compared to the attention physical health services and support have received. Thompson noted, “While some progress is evident, many of the issues we cited in 2018 have persisted and we must double down on industry commitment and accountability to address these issues moving forward.”
Methodology and employer profile
The online survey was conducted in February-March 2023 with responses from 221 private and public employers across the country representing over 10 million covered lives. Respondents could select up to five service providers to evaluate performance and had the option for each provider to indicate whether any specific requirement was out-of-scope or if they did not know how to evaluate (those responses were not included in the results).
About Path Forward
The Path Forward for Mental Health and Substance Use is a collaboration of influential non-profits working to realign market forces to achieve affordable access to high value, effective treatment. In addition to the National Alliance and HR Policy Association, members include the American Health Policy Institute, American Psychiatric Association, American Psychiatric Association Foundation Center for Workplace Mental Health, Bowman Family Foundation, The Goodness Web, Meadows Mental Health Policy Institute, and The Jed Foundation.
About HR Policy Association
HR Policy Association is the lead organization representing Chief Human Resource Officers at major employers. The Association consists of over 400 of the largest corporations doing business in the United States and globally, and these employers are represented in the organization by their most senior human resource executive. Collectively, their companies employ more than 10 million employees in the United States, over nine percent of the private sector workforce, and 20 million employees worldwide. These senior corporate officers participate in the Association because of their commitment to improving the direction of human resource policy. To learn more, visit hrpolicy.org.
About National Alliance of Healthcare Purchaser Coalitions
The National Alliance of Healthcare Purchaser Coalitions (National Alliance) is the only nonprofit, purchaser-led organization with a national and regional structure dedicated to driving health and healthcare value across the country. Its members represent private and public sector, nonprofit, and Taft-Hartley organizations, and more than 45 million Americans, spending over $400 billion annually on healthcare. To learn more, visit nationalalliancehealth.org.
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