Insurers criticized for preventing psychiatric care

A new study is criticizing health insurers in Massachusetts, where statewide reform has lead to innovative changes like global payments, for preventing patients from accessing timely psychiatric services.

Researchers at Cambridge Health Alliance and Beth Israel Deaconess Medical Center called 64 mental health facilities in Boston, posing as patients with Blue Cross Blue Shield insurance. They said they were evaluated for depression at emergency departments and discharged with instructions to get a psychiatric appointment within two weeks, according to the study, which was published as a letter to the editor in the Annals of Emergency Medicine.

However, only eight of the 64 facilities offered an appointment, and only four offered an appointment within two weeks. And one in four calls to providers were never returned, CBS News reports.

J. Wesley Boyd, lead author and attending psychiatrist at Cambridge Health Alliance, blamed the researchers' inability to access care on health insurers' "highly restrictive provider networks," notes CBS News. He added that the slow response also could be caused by health plans' low reimbursement rates for psychiatric services.

Insurers have "created a situation where a patient with a potentially life-threatening disorder, such as the severe depression portrayed in our callers' scenario, is essentially abandoned at a time of great need," Boyd said. "To have obstacles this big for someone who is suffering from some form of mental illness, it's really a very sad statement about reimbursement for psychiatric care," Boyd said.

Blue Cross Blue Shield disagreed with the study, alleging it was "an attempt to publicly pressure the state's health plans, like Blue Cross, to pay these clinicians more money which, frankly, is disappointing," spokesman Jay McQuaide told The Boston Globe.

He added that Blue Cross is concerned if doctors in its network turn away patients or don't return phone calls. In such cases, Blue Cross members can call the customer service line listed on their insurance card if they are having trouble, notes The Globe. "We would find them an appointment,'" McQuaide said.

To learn more:
- here's the study
- check out the Boston Globe piece
- read the CBS News story