Springfield Republican | Survey: Mental health patients turned away from treatment in Mass. over insurance issues

By Shira Schoenberg, Springfield Republican/MassLive.com
(Originally published on May 6, 2015. Read the full article here.)

Low insurance reimbursement rates and administrative challenges are affecting the way mental health professionals are practicing in Massachusetts, according to a survey of mental health professionals released Wednesday by the UMass Donahue Institute and commissioned by a group of mental health clinicians.

Christina Citino, a UMass Donahue Institute senior research manager, said the survey results suggest that issues related to the insurance company-doctor relationship, such as low reimbursement rates, “are affecting quality as well as access” to mental health care.

The survey was commissioned by CliniciansUNITED, an advocacy group of behavioral clinicians affiliated with the SEIU Local 509 union. Researchers received completed surveys from 785 clinicians, including 662 in private practice – primarily social workers, psychologists and mental health counselors.

The survey found that among private practice clinicians, 81 percent reported turning away at least one potential patient a month, and 44 percent turned away at least five potential patients per month. The most common reason for turning someone away, named by 61 percent of clinicians, was not being covered by the patient’s insurance.

The survey found cases of clinicians not wanting to join an insurer’s panel and, on the other hand, insurers not wanting to add clinicians to their panel. The vast majority of clinicians surveyed (84 percent) take at least one kind of insurance. But of those who take insurance, 35 percent had dropped off of one insurance panel in the last five years, a decision that was made 90 percent of the time because reimbursement rates were too low.

At the same time, 41 percent of clinicians, a majority of them mental health counselors, reported trying to join an insurance panel but not succeeding. The main reasons given were that the insurer was not accepting new providers in their service area (68 percent) or was not accepting any new providers (53 percent).

More than half of the clinicians reported that they had started taking fewer patients with particular insurance plans or they had changed their practice due to insurance company policies. A large number of those who made a change were working longer hours (41 percent), but large numbers also cut back on care, either by shortening sessions (28 percent), seeing patients less frequently (34 percent), accepting less complicated patients (34 percent) or taking more clients who could pay privately (29 percent).

The union is likely to use the study to try to gain support for a bill that would let clinicians bargain collectively for benefits like higher reimbursement rates from insurance companies.


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