In 2020, nearly one in four Americans accessed behavioral health care through their employer’s insurance plan, highlighting just how essential Employer-Sponsored Behavioral Health Benefits have become in the broader healthcare landscape. This insight comes from AHIP’s Coverage@Work report, which analyzed claims data for 41 million people—including 6 million children—and reveals how employer health plans are playing a pivotal role in making mental health and substance use services more accessible and affordable.
The analysis used data from the IBM MarketScan Commercial Database covering medical and pharmacy claims from 2016 through 2020. It tracked treatment for common mental health and substance use conditions such as anxiety, depression, bipolar disorder, ADHD, schizophrenia, and substance abuse involving opioids and alcohol. Of the 41 million people studied, more than half—around 22 million—received behavioral health support through a primary care provider (PCP), including pediatricians. Another 13 million engaged in individual or group psychotherapy, highlighting the broad reach of Employer-Sponsored Behavioral Health Benefits in connecting employees and their families with professional mental health services.
Primary Care and Psychotherapy: Two Critical Access Points
Primary care providers were often the frontline resource for mental health care, with patients averaging three behavioral health-related visits per year. Psychotherapy patients averaged about ten sessions annually. These numbers illustrate that Employer-Sponsored Behavioral Health Benefits support not just one-time care, but sustained treatment relationships. PCPs play a critical role in holistic care, addressing both physical and emotional well-being, while therapists, psychologists, and social workers offer specialized support for complex issues.
Telehealth’s Breakthrough Year
One of the most transformative shifts in 2020 was the rise of telehealth. Prior to the COVID-19 pandemic, telehealth accounted for a negligible share of mental health visits—just 0.39% of psychotherapy sessions and 0.5% of PCP visits in 2019. But in 2020, telehealth skyrocketed to 39.4% of psychotherapy visits and 30.1% of PCP visits for behavioral health. This unprecedented shift—driven by necessity during the pandemic—revealed how Employer-Sponsored Behavioral Health Benefits can quickly adapt to ensure continuity of care. By removing barriers like commutes, time constraints, and stigma, telehealth expanded access to care for millions of employees.
Making Medications More Affordable
Affordability remains another critical factor in making behavioral health treatment sustainable. The report found that 80% of behavioral health prescriptions filled through employer plans were for generic medications. These generics offer a dramatically lower out-of-pocket cost—averaging less than $15—compared to brand-name prescriptions without generic alternatives, which average about $100. This cost difference underscores how Employer-Sponsored Behavioral Health Benefits make long-term medication management more financially feasible for working individuals and families.
Public and Private Roles in Behavioral Health Spending
The report also reminds us that while employer-sponsored coverage is crucial, public health plans like Medicaid and Medicare cover the majority of national behavioral health costs. According to a Substance Abuse and Mental Health Services Administration (SAMHSA) analysis, the U.S. spent approximately $280.5 billion on behavioral health services in 2020. Of that, 64%—roughly $179.4 billion—was funded by public programs, while 36% ($101.1 billion) came from private sources including employer insurance and out-of-pocket payments. Medicaid alone accounts for 30% of all behavioral health spending.
The Risk of Losing Coverage
Yet this public-private balance faces potential disruption. With the end of the COVID-19 public health emergency, millions of Americans could lose access to Medicaid coverage. For many, Employer-Sponsored Behavioral Health Benefits may be the next best—or only—option to maintain access to crucial mental health care. Employers are now more responsible than ever for ensuring their health plans offer strong, flexible behavioral health coverage options.
Why Employers Must Take Action
The data from AHIP’s Coverage@Work report ultimately makes a compelling case for strengthening and expanding Employer-Sponsored Behavioral Health Benefits. As demand for mental health and substance use treatment continues to grow, especially post-pandemic, employers can make a direct impact by offering comprehensive behavioral health resources, expanding provider networks, promoting telehealth, and ensuring coverage for both therapy and medications. These benefits not only support employee well-being but also contribute to workplace productivity, retention, and morale.
Looking Ahead: A Mental Health Priority
In conclusion, Employer-Sponsored Behavioral Health Benefits are no longer a fringe perk—they are a cornerstone of a healthy workforce and a healthier nation. With millions relying on their workplace insurance to access care, the future of mental health depends on how effectively employers continue to invest in these essential services. Whether through in-person support, virtual therapy, or affordable prescriptions, the evolution of Employer-Sponsored Behavioral Health Benefits will play a defining role in the ongoing effort to address America’s mental health crisis.
