Mental health can affect physical health

Although the mind and body are sometimes viewed as separate, mental and physical health are closely related. Poor mental health can negatively affect physical health and lead to serious complications — including heart disease, high blood pressure, weakened immune system, asthma, obesity and gastrointestinal problems.

If an employee who needs mental health care can’t access an in-network provider and chooses not to seek out-of-network care, the physical health risks mentioned may come into play, further reducing productivity and leading to increased health care expenses.

Behavioral health care is a valued benefit

Not surprisingly, more and more employees need and are seeking behavioral health services. A telling sign is that two of the country's biggest unions have joined a coalition calling on federal regulators to protect workers' mental health the way they enforce standards for physical health and safety.⁶

A law passed in 2008, The Mental Health Parity and Addiction Equity Act, requires coverage of services for mental health, behavioral health and substance use disorders to be comparable to physical health coverage.

In the interest of helping meet employees’ growing mental health needs, many employers are including more robust behavioral health benefits in their plans. In a recent Mercer survey of large employers, most respondents identified mental health resources as one of their most valued benefits.⁷

More therapists are needed. Many more.

Fully 76% of Americans see mental health as important as physical health, and more people than ever are seeking behavioral health services. So, it’s not surprising that qualified providers are in short supply. Limited options and long waits for care have become the norm. 

According to a recent survey by the American Psychological Association, many psychologists report no longer having the capacity to see new patients.⁸ The Kaiser Family Foundation reports, “47% of the U.S. population in 2022 was living in a mental health workforce shortage area, with some states requiring up to 700 more practitioners to remove this designation.” ⁹

This shortage of service providers is causing some employees who would prefer to get behavioral health care in-network to seek out-of-network care instead. Ultimately, addressing out-of-network health care costs requires careful consideration and planning from employers to select health care benefits that successfully prioritize employee well-being.

How Naviguard may help

Naviguard^® is a service added to UnitedHealthcare^® plans that reviews and resolves out-of-network balance medical bills. Naviguard agrees with employers who believe it’s vital for their employees to get the behavioral health care they need. 

Although it’s preferable for employees to receive that care from an in-network provider, there are times when going out-of-network may be necessary — especially given the serious shortage of mental health professionals, or if an employee has an established relationship with a trusted provider.

With Naviguard, employers help support employees who go out-of-network to get the behavioral health services they need. Naviguard also helps support the established relationship some employees have with their out-of-network provider.

Keep in mind that going out-of-network may mean paying a high balance bill. Take a look at these average costs for all behavioral health services, including in-patient and out-patient care:

• Out-of-network behavioral health provider’s billed amount: $4,623.25¹⁰
• Insurance plan allowed amount: $602.83¹⁰
• Potential balance bill amount: $4,020.48¹⁰

To help make going out-of-network for behavioral health care more affordable, Naviguard offers simple and efficient balance bill resolution options, including out-of-network billing education and, when appropriate, custom negotiation directly with providers. In fact, we’ve helped tens of thousands of UnitedHealthcare members resolve out-of-network balance bills, reducing the original billed amount by an average of 77%¹¹ (success rate applies to all services, not just behavioral health).

We are uniquely positioned to lower out-of-network costs and simplify the health care experience for everyone. By addressing balance billing for out-of-network mental health coverage, employers can help make health care more affordable for their employees — while enabling them to get the care they need. It’s a win/win for employers and their employees.

RESOURCES

• 5 ways to help employees find the behavioral health care they need
• Supporting employees who have children with mental health needs
• More employees deferring care may mean higher costs for employers
• Research: State of the nation’s health

REFERENCES

1. “America Has Reached Peak Therapy. Why Is Our Mental Health Getting Worse?” Time, August 28, 2023 
2. “Behavioral Healthcare: Overview” The Center for Health Affairs  
3. “Mental Health Disorder Statistics” Johns Hopkins Medicine
4. “About Mental Health” Centers for Disease Control and Prevention
5. “What is behavioral health” American Medical Association, August 22, 2022
6. "Unions press feds for more workplace mental health protections” Axios, September 20, 2023
7. “Employers are getting more creative on benefits” Axios, September 26, 2023
8. “Increased need for mental health care strains capacity” American Psychological Association, November 15, 2022
9. “Demand for behavioral health services outstrips supply of providers, driving higher costs, analysis finds” Fierce Healthcare, June 13, 2023
10. Naviguard Data, March 5, 2023 – March 5, 2024 (Cost averages are based on all behavioral health services for both in-patient and out-patient care)
11. "Don’t pay out-of-network balance medical bills without contacting us first” Naviguard, March 6, 2024