National Business Coalition Sees Disparities in Access & Quality of Mental Health and Substance Use Support

National Alliance of Healthcare Purchaser Coalitions releases roadmap for corporate America to improve behavioral health delivery

WASHINGTON – Sept. 13, 2018 – It’s estimated that for every dollar spent in improved treatment for common mental disorders, there is a return of four dollars in improved health and productivity.* However, US employers are not realizing the value of this investment according to a new report released by the non-profit National Alliance of Healthcare Purchaser Coalitions as clear disparities exist for access to behavioral health when compared to the attention physical health services and support have received.

“There’s no question that our mental health system needs work and we’re collaborating with key stakeholders and our network of member coalitions to broker real solutions for very serious issues,” said Michael Thompson, president and CEO, National Alliance. “Conditions like depression, anxiety and substance use disorders are prevalent among the US workforce and employers must ensure affordable and improved access to quality support for employees and their families. Parity is the law – and improved performance is good business.”

The report, Achieving Value in Mental Health Support: A Deep Dive Powered by eValue8, and the accompanying Mental Health Action Brief shine a light on the underlying gaps in mental health care and related benefits administration based on the National Alliance’s annual eValue8 survey of health plans.

“Supporting the mental health of our employees and their families is foundational to our organization’s total health and safety agenda,” said Andrew Crighton, MD, vice president of Global Health and Medical and chief medical officer for Prudential Financial, Inc., and a member of the National Alliance Mental Health Purchaser Advisory Committee. “We need our vendor partners to be similarly aligned and this report reinforces key gaps that must be addressed.”

The independent and comprehensive assessment offers employers specific steps to ensure health plans, benefits administrators and providers improve access to and delivery of quality behavioral health support. This report builds on two landmark 2017 studies conducted by Milliman and RTI International which found dramatically lower payments to behavioral health providers and extremely high out-of-network use for patients with mental health and substance use disorders.

Identified employer concerns include: (1) lack of consistent and timely access to clinicians and medications for employees in their network; (2) inconsistent use of measurement-based care among primary care physicians or specialists; (3) continued stigma and silence around behavioral health conditions in the workplace; and (4) escalating suicide- and opiate-related death rates. Employers are liable for parity compliance, and with increased federal attention to these insurance violations, the stakes are high for employers to act.

Purchaser recommendations include:

  • Improve access by ensuring affordable access to quality networks; promoting and reimbursing for collaborative care in primary care settings; offering alternative delivery models such as telehealth; integrating employee assistance plans into a broader employer total health strategy; and ensuring access to medications through benefit design.
  • Advance quality and performance by implementing early identification and intervention; measuring behavioral health performance including accountability metrics; and integrating mental health within total health and wellbeing strategies.
  • Change the environment by stressing the impact of mental health on broader functioning, workplace performance and physical health costs; implementing strategies to break the silence and mitigate stigma; and developing a culture of wellbeing and performance to mitigate chronic stress.

“In this era of escalating suicide rates and opioid overdose deaths, there is an urgent need for employers to appreciate the key role they play in ensuring that their employees and families have access to high quality mental health services and treatment,” said Henry Harbin, MD, a psychiatrist, former CEO of Magellan Health Care, and noted expert on mental health parity. “Each employer has the power to act on the recommendations in this report to ensure people who seek help can get it, and that mental health and substance use disorders are treated the same way as physical health conditions by their plans and providers.”

The report, which looked at how eight leading health plans and behavioral health organizations deliver behavioral health services, was developed in collaboration with and sponsored by the American Psychiatric Foundation, the Center for Workplace Mental Health at the American Psychiatric Association, Clear Health Quality InstituteTakeda Pharmaceuticals and Lundbeck; and recommendations and support for the action brief were provided by the Herman Foundation and Mental Health Association of Maryland. The National Alliance Mental Health Purchaser Advisory Committee, consisting of seven purchasers from across the country including Best Buy Co., Inc., FedEx Corporation, McMurry Cos, Prudential Financial, Inc. and US Office of Personnel Management and five coalitions – Memphis Business Group on Health, MidAtlantic Business Group on Health, Minnesota Health Action Group, Northeast Business Group on Health and Pacific Business Group on Health – also offered significant input into the development of these resources.

Annual Forum
Improving mental health system access and quality is among the topics of discussion at the National Alliance 23rd Annual Forum. Convening employers, policymakers, business coalition leaders and other healthcare stakeholders, the Forum will be held November 12-14, 2018 at The Mayflower Hotel, Washington, DC. Registration information can be found here.

About National Alliance of Healthcare Purchaser Coalitions
The National Alliance of Healthcare Purchaser Coalitions is a nonprofit network of business coalitions, representing more than 12,000 purchasers and 45 million Americans, spending more than $300 billion annually on healthcare. The National Alliance is dedicated to driving innovation, health, and value along with its coalition members through the collective action of public and private purchasers. To learn more, visit and connect with us on Twitter and LinkedIn.

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