More than half of adults with a mental illness don’t receive treatment. Part of this is due to not only a lack of behavioral health providers, but also a lack of behavioral health providers who are in-network.
To be part of an insurer’s network, there are many hoops for behavioral health providers, said Cara McNulty, president of behavioral health and mental wellbeing at Woonsocket, Rhode Island-based CVS Health. They have to submit paperwork that includes information like their credentials, where they practice, what their specialty is and more.
“It’s just like an application process, which isn’t in itself overwhelming,” McNulty said in an interview at the AHIP 2023 conference held last week in Portland. “But if you’re not in a practice that has that infrastructure, if you’re a single provider and you’re seeing patients and have to apply, go through credentialing, sign an agreement, it just takes time. Bigger systems have administrative support to do all that. Often for mental health providers, it is just additional work.”
That’s why the behavioral health industry needs something similar to the “Common App,” which allows students to apply to multiple colleges through just one application rather than filling out multiple separate applications for each individual school. The Common App gives access to more than 1,000 colleges.
“Think how that changed the ecosystem. … We need innovation like a Common App because [the information needed] is very similar across all health plans,” McNulty said. “But you have to do it for the protection of the patient.”
Who would be in charge of a Common App for behavioral health? It could be a place like Psych Hub, which provides education and resources on mental health to patients, providers and organizations, McNulty said. Ultimately, however, it’s going to require partnerships across payers. Insurers need to come together to discuss what basic information they need from all mental health providers.
“These are conversations we’re in, whether it’s with advocacy organizations and associations like AHIP. … We’re all trying to work together to say, ‘How can we make this easier for providers?’ Because not having providers who take insurance is not a win/win for anyone.”
She added that there are ways providers can help, too, such as keeping the information they share with insurers updated.
“If they’ve moved and they don’t let us know, then we might be sending the data or the information to the wrong address,” McNulty said. “But again, if you’re a single provider, it’s extra work for them to do.”
In addition, the more providers can show clinical outcomes and that their services are driving improvement, the “better we all are,” McNulty said. It’s also helpful for them to share their race and ethnicity so that patients can find providers who understand their personal experiences.
But more broadly, the U.S. needs more mental health providers as well. About 163 million Americans live in areas with mental health provider shortages, and more than 8,000 practitioners are needed to fill the gap, according to the Health Resources and Services Administration. More needs to be done to inspire people to go into the field, McNulty said.
“The pandemic has raised this great awareness on mental health,” she stated. “But people also see that there are not enough providers and there probably hasn’t been enough advocacy to encourage people to get into the field.”