Patients’ Reasons for Using Out-of-Network Mental and General Medical Health Providers

The authors sought to assess why patients use out-of-network health care providers and whether patients’ reasons differ for mental and general medical health providers.

In a national Internet survey of commercial plan enrollees (N=713) who used an out-of-network provider, participants indicated whether 12 reasons were “important” (vs. “not applicable” or “not important”) in their decision to see an out-of-network provider.

Reasons for using out-of-network care were multifactorial. Six reasons were similarly important, including the three most-cited reasons: convenient location (66% vs. 69% for mental vs. general medical health, respectively), higher quality (65% vs. 69%), and affordability (70% vs. 71%). Reasons more commonly cited for using out-of-network mental health care were that in-network providers were not taking new patients (34% vs. 24%), confidentiality (33% vs. 19%), cultural competence (33% vs. 23%), and inaccurate in-network provider directories (30% vs. 22%).

The most common reasons for using out-of-network care were cited with similar frequency for both mental health and general medical health providers.