Article
What the index found
The Kennedy Forum’s Mental Health Parity Index draws on in-network rate files that insurers must publish under federal Transparency in Coverage rules. It compares two things within the same plan network and geography: how many in-network mental health and substance use providers there are relative to physical health providers, and how much insurers pay for outpatient mental health and substance use services compared with outpatient physical health care, measured as a percentage of Medicare.
According to AHA News, which reported the findings on April 16, the analysis covers people in 43 states enrolled in plans from Aetna, Blue Cross Blue Shield, Cigna and UnitedHealthcare. It identifies potential gaps in finding in-network mental health and addiction care compared with physical care, and it finds lower outpatient payment for mental health and substance use treatment than for physical care in all 43 states. The AHA advised on the analysis.
Why hospitals should care
Thin behavioral health networks do not make demand disappear. Patients who cannot find an in-network therapist or psychiatrist often end up in the emergency department, where some wait days for an inpatient bed. Hospitals carry the staffing and safety costs of that boarding, often with little added payment.
Low commercial rates also make it harder for hospitals and their employed groups to recruit psychiatrists, psychologists and therapists, and to justify keeping inpatient psychiatric units and outpatient programs open. Behavioral health is often a money-losing service line for hospitals.
Putting the data to work
- Benchmark your contracts: Compare your behavioral health rates with your physical health rates for the same payers, using the index and your own contract data.
- Raise it at the table: Make behavioral health rate parity an explicit item in your next negotiations, backed by numbers.
- Document network gaps: Track discharge delays and ED boarding tied to a lack of in-network follow-up care, by payer.
- Use regulators: Share findings with your state insurance department and attorney general, which enforce parity laws for state-regulated plans.
- Brief employers: Large local employers that buy coverage may push insurers to fix network gaps their own workers face.
Archive entry for Apr 19, 2026, added Nov. 11, 2026.