Payers Fall Short of Employer Expectations on Behavioral Healthcare

April 28, 2023 - Employers agree that behavioral healthcare is a critical element of employer-sponsored health plan benefits, but more than three in ten found their payer’s behavioral healthcare benefits disappointing, a survey from the National Alliance of Healthcare Purchaser Coalitions (National Alliance) found.

The survey was fielded from February 2023 to March 2023 online. It garnered responses from over 220 employers from a range of industries.

Employers overwhelmingly supported behavioral and mental healthcare benefits, with 99 percent affirming that access to behavioral healthcare is crucial, but finding a health plan that would satisfactorily deliver on these demands was more challenging.

“Supporting the mental health and wellbeing of employees and their families is a top priority for major employers,” Mark Wilson, vice president of health and employment policy and chief economist for the HR Policy Association, said in the press release.

“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.”

Employers also prioritized identifying and addressing gaps in access to in-network care, enabling timely appointments, and offering a provider directory that presented accurate information. However, their health plans fell short of these goals.

Slightly more than three out of ten were dissatisfied with payers’ abilities to find and fix gaps in care access. A third of employers were not satisfied with payers’ efforts to support timely access to behavioral healthcare. More than a quarter of employers stated that they were “somewhat dissatisfied” or “dissatisfied” with their health plan’s directory accuracy for in-network behavioral healthcare providers who were accepting new patients (26 percent).

Quality of care also received mixed responses. More than half of the employer respondents reported satisfaction with standardized quality of care measurements in behavioral healthcare. Additionally, 86 percent of the respondents were satisfied or somewhat satisfied with how their health plans promoted mental healthcare screenings for members.

However, patient outcomes were not as positive: 24 percent of employers were not satisfied or were somewhat dissatisfied with their payers’ reports on engagement with behavioral healthcare services and behavioral healthcare outcomes.

Moreover, employers expressed dissatisfaction with their health plans’ commitment to health equity. Almost 30 percent of the survey participants were dissatisfied or somewhat dissatisfied with how their behavioral healthcare benefits served minority communities.

Employers also found that integration of behavioral healthcare into primary care was lacking. Four out of ten employers stated that they were dissatisfied with how their plans indicated whether a primary care practice had integrated behavioral healthcare in their directories.

Additionally, more than a quarter found their plans’ primary care training on improving access to behavioral healthcare specialists was lacking. A fifth said that they were dissatisfied with how their plans incentivized integration and 18 percent were dissatisfied with systemic measurement of behavioral healthcare.

With this level of dissatisfaction, it is unsurprising that employers were also dissatisfied with the results in their workplaces.

Forty percent were dissatisfied with their health plans’ supervisor-level behavioral healthcare training options and 21 percent were dissatisfied with payers’ stigma reduction and behavioral health awareness programs. Nearly a third were dissatisfied with workplace engagement in behavioral health programs. And 27 percent found that whole-person integration was lacking.

“Our study found a strong employer consensus on what is critical and significant variation in health plan and vendor performance,” Michael Thompson, president and chief executive officer of National Alliance, shared in the press release.

“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.”

Building a wellness culture in the workplace requires employer support. Historically, there has been a divide between employees and employers on what constitutes a strong wellness program. But there are steps that employers can take to assess and create a stronger wellness culture in their work environments.