Behavioral Health Network Adequacy Standards: How Can We Improve Measurement of Access to Care?
Date & Time
Tuesday, October 24, 2023, 8:30 AM - 8:45 AM
Digital Innovation Theater

Maintaining a sufficient number of providers who are qualified and available to deliver behavioral health services is now more important than ever. Health plans are facing escalating workforce shortages and high numbers of behavioral health providers opting out of contracts, making it difficult to meet increasing behavioral health needs. To better understand network adequacy standards for behavioral health and best practices in developing standards, NCQA conducted an environmental scan including a review of recent literature, existing State and health plan standards, as well as interviews with industry leaders. Preliminary findings point to the importance of developing standards that rely on service instead of provider type, differentiate mental health from substance use providers, and include non-traditional providers.  Findings illuminated the pros and cons of telehealth and behavioral health integration in expanding networks. Multiple meaningful network adequacy metrics were identified by stakeholders, as well as metrics that provide more limited use.

Julie Seibert Sarah Sweeney