Price Sensitivity Among Patients Receiving Outpatient Behavioral Health Services: A Retrospective Cohort Analysis

Abstract The prevalence, acuity, and costs of behavioral health conditions in the USA have risen sharply over the past decade, and over 40% of adults with mental illness report cost as a barrier to accessing care. The objective of this study was to evaluate patients’ sensitivity to out-of-pocket (OOP) costs for in-network behavioral health office visits, adjusting for patient acuity. The authors evaluated data from patients in all 50 states who received care from the largest outpatient behavioral health group in the USA, had a first visit during 2024, and were followed for 12 months. Patient OOP cost was assessed for each visit, and linear regression models were used to estimate the association between OOP cost and number of office visits. Among the 425,423 commercially insured individuals included, 68.9% identified as female and their mean age was 33.5 years (SD 11.2 years). Increased OOP costs were significantly associated with fewer visits: for every $10 increase in OOP cost, patients had, on average, 0.50 fewer office visits, corresponding to a price elasticity of approximately − 0.15 at sample means. The number of office visits was not associated with clinical acuity, age, gender, or social vulnerability. Patients were more price sensitive for visits with a psychotherapist than with a psychiatric prescriber. These findings underscore the need for policy solutions that address the affordability of outpatient mental health services. Anticipating financial barriers to care can inform expectation setting for providers and patients early in the course of mental health care.