While there is a great deal of discussion concerning a nationwide mental health crisis, there has been very little attention given to what is perhaps the greatest barrier to care: commercial insurance plans that do not provide sufficient access to behavioral health services.
A recent study by the Healthy Minds Policy Initiative looked at gaps in Oklahoma’s commercial insurance networks. It documented the struggles that too many of us face when trying to find mental health and substance use care. The overarching theme of the report was very clear. Even though we pay for coverage, using our health plans to find services when in need is often difficult and overwhelming.
Healthy Minds found that any given health plan in Oklahoma omits at least 70% of licensed behavioral health providers in the state. As you might imagine, that significantly complicates a person’s ability to find a provider in their area. To make it worse, when Healthy Minds tried to contact a sample of providers listed as in-network by various plans, barely a third were reachable. Listed contact information was often not accurate.
If fortunate and persistent enough, you might find a provider on your plan to accept clients, but you will likely have to wait. It might be months before they can work you in. It becomes more difficult if you live in rural Oklahoma, where nearby providers are that much harder to find. This is unacceptable, especially when about 900,000 or more Oklahomans are experiencing behavioral health challenges annually. And this report is just the tip of the iceberg. There are other issues to address, such as inappropriately low reimbursement rates, system structures that make it difficult for behavioral health providers to participate with plans, claim denials, slow payments and more.
Over the years, I’ve spoken to countless Oklahomans who have shared their stories about the inability to find a provider on their plan, long waits for services and high out-of-pocket costs. For many, insurance doesn’t work when it comes to mental health care. The Healthy Minds report simply documented what we already knew.
Oklahoma insurance companies think the criticism is unfair, but I am not saying all insurance companies are bad or they do not want to provide quality services; however, you can’t ignore the experiences of so many. These companies are operating in accordance with the status quo. But we are now in an environment where more and more people are aware of just how important behavioral health services are for remaining healthy and productive, to keep their families whole and to reverse so many of the negative consequences impacting our communities and state. As the Healthy Minds report shows, the status quo isn’t working.
We can change this. Let’s seize the opportunity to bring everyone to the table — insurers, policy makers, businesses, providers and advocates — so we can create a behavioral health system that serves all Oklahomans. This is a complex problem that is rooted in a stigma that we have yet to completely eradicate. Now is the time to tackle this issue head-on, and it will take all of us working together to create and implement the right solutions.
Our legislative leaders have done a tremendous job of advancing state behavioral health services in recent years along with innovative programs and expanded resources. They have begun efforts to address the issues raised in the Healthy Minds report, and Oklahomans should encourage their representatives to collaborate with insurers and the behavioral health community on further reforms. We must ensure that Oklahomans have access to the right care at the right time, so that they can be well. By working together, we can make that happen and create a new status quo.
Jeff Dismukes is the executive director of the Depression and Bipolar Support Alliance of Oklahoma.