Report: Out-of-network visits for mental health, substance use remain high in R.I.

PROVIDENCE – Rhode Islanders regularly venture out of network for mental health care and substance-use treatment, according to a national report released last week.

The survey, by Seattle-based consulting firm Milliman, shows that the Ocean State ranks worse than the national average when it comes to access to in-network behavioral health care.

During the five-year period of the study, Rhode Islanders went out of network more than five times, or 530%, for inpatient behavioral health treatment versus medical care. That rate outpaces the national figure of 524%.

Researchers combed through health insurance plans from 2013 to 2018 to highlight how often patients sought behavioral health care outside of their private insurance plans.

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Nationally, they found that mental health and substance-use treatment brought in 3.5% of health care reimbursements, with substance-use treatment accounting for 0.7% to 1% of that total.

In 2017, Rhode Island patients were 428% more likely to go out of network for a mental health visit than for a primary care visit, as compared with 228% more likely in 2013, according to the survey.

Disparities extend to providers as well. Researchers found that in 2017, Rhode Island mental health professionals were paid 23.4% less than other specialists who had performed similar services, such as evaluating or managing a condition.

“Rhode Islanders who desperately need help and are legally entitled to it under federal and state mental health parity laws continue to languish without adequate care,” said Laurie-Marie Pisciotta, executive director of the Mental Health Association of Rhode Island. “MHARI is working hard, through our R.I. Parity Initiative, to demand compliance by insurers and improvements in reimbursements to mental health professionals that are critical to building a system of care that our state can be proud of.”