Why can’t you find a therapist who takes insurance? • New Hampshire Bulletin

(Allison Doyle, LMFT, Dave Meichsner, LICSW, Heidi Page, LICSW, and Shawn Hassell, LMFT, of Clinicians United New Hampshire contributed to this commentary.)

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Despite a growing need for mental health services, it is becoming increasingly difficult to find care.

Finding a mental health provider in your insurance network, who has openings, can be an arduous process. Clinicians United New Hampshire (CUNH) is currently hearing from more and more therapists deciding to leave insurance panels at an alarming rate. This trend has led to New Hampshire having one of the highest rates of paying out of pocket for therapy. As a result, the pool of therapists taking insurance has shrunk and the cost of care has skyrocketed.

Many families are stretching their budgets or are choosing to forego treatment because of cost. Surveys of local therapists demonstrate the problem is only getting worse. Recent surveys from the New Hampshire Psychological Association (NHPA) and the New Hampshire Association for Marriage and Family Therapy (NHAMFT) found that an increasing number of therapists plan to leave insurance panels in 2025 and beyond. 

Here are the concerning trends:

• 27% of providers have left an insurance panel in the last five years (NHPA).
• 26% plan to leave one or more in the near future (NHPA).
• 50% of NHAMFT members plan to leave an insurance panel within the next one to two years.
• 79% of therapists have a hard time finding another provider to refer patients to when needed (NHPA).

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Therapists are making the difficult decision to leave insurance networks due to practices used by insurance companies that make it unsustainable to remain in their networks. Individual therapists and small practices are facing growing hours of unpaid administrative time to deal with unlawful delays in joining networks, fixing inaccurate quotes of benefits and data entry errors, and improper claim denials. There are long wait times for reimbursement, not being paid at all, audits, and unilateral decisions to take money back for previously paid claims.

Insurance company provider service departments are undertrained, understaffed, and overworked. This is compounded by the increasing need to file complaints to the New Hampshire Insurance Department to attempt to hold insurance carriers accountable to state laws. The increase in administrative burden directly reduces a therapist’s time with patients and their ability to take on new ones.

Patients seeking services for children, families, and couples face the most difficult road to finding a therapist. According to NHPA, New Hampshire has a severe shortage of therapists who treat children and families. Family, children, and couples therapy requires more training and is more complex than one-to-one therapy.

Insurance guidelines dictate these services be delivered in shorter time increments than individual therapy and are continuously devalued year over year, even as demand grows. This contributes to many therapists who treat these populations to see more individuals to remain in business, effectively limiting care to these populations.

This is an unsustainable recipe for a functional mental health system.

These issues contributed to Anthem owing New Hampshire hospitals over $300 million in unpaid claims and MaineHealth dropped them as a carrier due to $70 million in outstanding claims. CUNH has heard from a multitude of individual therapists, small practices, and community mental health centers reporting being out months of payments.

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If larger hospital systems with dedicated billing departments are struggling to obtain reimbursement, individual therapists and small practices do not stand a chance. The more clients are kept out of treatment and payments are delayed, the more money insurance carriers can keep from premiums; it’s designed for patients and practices to lose.

A spotlight is being pointed at health insurance practices and glimmers of accountability have started to appear. Reuters recently reported that Anthem Blue Cross Blue Shield agreed to settle an antitrust lawsuit for $2.8 billion for claims their practice of dividing the country into exclusive areas where they did not compete led to increased costs for patients and drove down reimbursements to providers. While Anthem agreed to settle the case, they continue to deny these allegations.

The news outlet ProPublica has uncovered schemes used by companies like Cigna, Anthem, and UnitedHealth Group of using artificial intelligence to increase denials and alter therapist treatment, allegations all three deny. These are three of the top 10 largest insurance companies in the United States and three of the largest in New Hampshire. We cannot have a functional mental health system if that system only works for one party.

To address this urgent and growing issue, CUNH is recommending:

• The New Hampshire Insurance Department needs increased authority to enforce both federal parity laws and state insurance laws currently in place.
• Penalties for insurance companies not complying with state laws need to be increased.
• Behavioral health providers need a mechanism to stand on equal footing with insurance companies.
• Insurance companies need to provide adequately staffed provider service departments.
• Increase investment in services for family, couples, and children.

For better or worse, our health care system is designed for patients to use their health insurance to receive care. The only recourse for providers should not be to leave that system as it only stands to hurt the very patients we are trying to serve. The fact that insurance companies control so much of the market means they have an ethical duty to partner in their paying member’s care and with their contracted providers to improve the health of our citizens – a responsibility they are choosing not to live up to.

New Hampshire deserves better.