Health insurers have been quietly buying up physician practices across the United States, expanding their reach into people’s medical adventures. And now they are expanding efforts to deliver mental health treatment.
“UnitedHealthcare has expanded access to its child and family behavioral coaching program to approximately 13 million eligible members, increasing availability of early behavioral health support for children, teens and caregivers through its commercial plans,” UnitedHealth wrote in a press release in August.
“The coaching program is intended to help support families with low-severity behavioral health concerns, with a focus on early intervention and education. The expansion follows increased interest from employers and families in behavioral health support options.”
Aetna announced something not dissimilar in May, announcing “Aetna Mental Health On Demand to provide real time access to care and ongoing support.”
“With Aetna Mental Health On Demand, members aged 13 and older have real-time access to a licensed clinician through chat, phone or video via the Aetna member website,” Aetna wrote in a press release in May of this year. “Aetna clinicians are trained on a clinically-proven single session intervention model, which is designed to provide members with both immediate impact — including crisis management — and a personalized plan. They also advocate for members, helping to connect them to additional resources, assist with scheduling follow-up appointments and help coordinate their ongoing care. AI-powered tools embedded within this dynamic platform streamline note-taking and administrative tasks, allowing clinicians to remain fully focused on each member and their immediate needs.”
Mental health parity
The moves are significant especially in light of insurers’ frequent failures to cover mental health treatment.
The Mental Health Parity and Addiction Equity Act, passed in 2008, was intended to correct insurers’ failure to provide the same level of access to mental health care as medical-surgical care. Insurers often refuse to approve care, underpay mental health providers and make it hard for patients to find help. Biden administration rules required health plans to gather and report data on how they restrict or deny mental health claims, and if they found disparities, to explain what they were doing to fix the problem. But the Trump Administration put those rules on hold, meaning that there’s no enforcement to cause insurers to comply with the 2008 act.
And insurers’ increasing moves into behavioral health demonstrate that there’s no check on their plans.
The Psychotherapy Action Network, an advocacy group, wrote of the rollback in 2025: “This is a deeply troubling development. By pausing enforcement and potentially revising or rescinding the rule, the federal government is signaling a retreat from its responsibility to legally protect mental health parity. What this means is that the 2024 rule is now unenforceable, and the regulatory clarity it aimed to offer clinicians and patients is disappearing.
“To be clear: this rollback does not repeal the 2008 act itself. The bipartisan Mental Health Parity and Addiction Equity Act of 2008 remains in force and must continue to be upheld. … What is being undermined is not the law but the federal government’s willingness to enforce it through the regulatory tools designed to make parity real in practice.
“At a time when our country is navigating a mental health crisis, this is the worst possible moment to delay federal enforcement. Clinicians understand that parity is essential not only to comply with the law but also to provide equitable, patient-centered care. The Trump Administration’s decision undermines years of bipartisan work to hold insurers accountable and threatens the infrastructure of mental health care delivery.
More insurance therapy
Cigna launched Evernorth Behavioral Care Services in 2024, with plans to reach as many as 15,000 providers across all 50 states. It’s offering in-person appointments and digital ones with considerable use of its virtual partner, Octave.
Blue Shield of California, which was outsourcing some of its behavioral health to a third-party manager, decided to bring everything in-house earlier this year. Virtual Blue, which launched in 2023, is now expected to reach $150,000 members with virtual care, including behavioral health.
United Health subsidiary Optum bought an outpatient mental health provider called Refresh Mental Health in 2022. Refresh has more than 300 outpatient locations in 37 states dealing with things like mental health, substance use disorder, eating disorders, and psychiatric treatment. Optum also bought a virtual mental health provider named AbleTo in 2020.
Elevance Health has a division that used to be called Carelon and is now Beacon Health Options. It concerns itself with pharmacy, behavioral health, data services, prior authorizations and other kinds of care for more than 90 million consumers.
In October 2025, Elevance Health said it would “expand behavioral health interventions as a means to tighten medical cost management. The segment continues to experience elevated cost pressures and high acuity, driving higher utilization,” Behavioral Health Business reported.
“Elevance’s health care services subsidiary Carelon has continued to drive growth for its parent company. During its third-quarter earnings call, executives reported that further expanding external relationships and scaling services like behavioral health will be an ongoing priority.”
The report added that “executives did not touch on the ongoing lawsuits related to ghost networks that Elevance Health and Carelon have been involved in throughout the last year.” Ghost networks are networks that profess to have substantial enrollment from providers but those providers are either not taking patients, have faulty contact information or are completely out of business, a big and growing problem in behavioral health.
