For years, the legal promise of mental health parity, which requires that mental health and addiction services be covered no more restrictively than physical health services, has not always translated into practice. As a result, millions of Americans continue to face barriers to accessing timely, affordable, and high-quality care.

The Mental Health Parity Index provides a new way to assess parity quantitatively — and offers an unprecedented opportunity for payers and plans to help people live healthier lives. Built on real-time data from America’s leading insurers, the Index leverages in-network payer files to highlight where access and coverage breaks down and where action can drive measurable improvement.

Launch the Parity Index
The Index was launched by The Kennedy Forum in collaboration with Third Horizon, the American Medical Association, the American Psychological Foundation, and Ballmer Group, with review and guidance from dozens of premier organizations. The tool equips stakeholders with information that helps strengthen networks and move toward quality, evidence-based solutions that work for patients, providers, and insurers alike.

The release of the national Mental Health Parity Index finds that commercially insured Americans are likely facing widespread access gaps to mental health and substance use care relative to physical health services:

  • In 43 states, enrollees in plans offered by the nation’s four largest commercial health insurance companies face potential disparities in finding in-network mental health care and substance use disorder treatment relative to physical health care.
  • Locally, 7 in 10 counties face similar issues, potentially making it harder for patients to find in-network mental health care or substance use disorder treatment where they live.

The majority of mental health and substance use providers are reimbursed less than physical health providers on a relative basis, potentially driving lower provider participation in insurance networks:

  • Across the nation’s four largest commercial health insurers, all 50 states have lower payment levels for outpatient mental health care and substance use disorder treatment relative to outpatient physical health care.
  • On average, mental health care and substance use disorder treatment is paid between a 16% to 59% difference from physical health care nationwide for the four major insurance networks analyzed.

While no insurance company achieves comparable network composition, some commercial networks were found to meet or exceed parity metrics in select states or counties, opening an opportunity for an informed and targeted conversation about why metrics differ across the plans and geographies.

What the Index Measures

Network Composition: The relative percent difference of in-network providers for MH/SUD care compared with physical health providers in the same geography within the same insurance plan networks.

Outpatient Professional Reimbursement: A relative comparison of in-network contractual rates for outpatient MH/SUD services compared with outpatient physical health services by insurance network in the same geography and expressed as a percent of Medicare.

Launch the Parity Index

Background

Parity Evaluations at the State and National Levels
Gaps in parity are difficult to address without visibility. The federal Transparency in Coverage (TiC) rules made new data available, and we put that information to work. The Mental Health Parity Index began as a pilot project in Illinois and expanded nationally about one year later. With support from the New York Community Trust, we will also work to detail metrics affecting New York’s 11 million commercially insured residents. States can also partner with the organizations behind the Mental Health Parity Index to conduct deeper analyses of their parity landscape. Contact The Kennedy Forum if you would like to explore options for your area.

The Parity Index and Mental Health Parity in America
The bipartisan Mental Health Parity and Addiction Equity Act (MHPAEA), co-authored by Congressman Patrick J. Kennedy and signed into law in 2008, established protections intended to ensure that individuals seeking mental health and addiction care receive health insurance coverage comparable to coverage for physical health conditions.

Nearly two decades later, parity remains unrealized for many of the 156 million Americans with commercial insurance. Individuals seeking mental health and addiction services continue to experience higher rates of out-of-network care and higher out-of-pocket costs than those seeking physical health services. These disparities contribute to delayed treatment and create unmet needs nationwide.

The Mental Health Parity Index builds on efforts such as Parity Track and the Parity Registry to provide a more comprehensive evaluation of the country’s progress toward true parity and quality, accessible health care.

Take Action

Tell Your Story: If you are a consumer or provider, we want to hear about coverage denials and access barriers. These stories help inform lawmakers and decisionmakers about the real-world impact of parity challenges. Please record the details of your experience here.