While workforce shortages are often to blame, insurance company practices are driving therapists into private practice, he said Task Force Report: Bridging the Mental Health Care Gap Report from Inseparable, a group advocating for access to mental health across the country.
Low wages, high education costs and provider burnout are the main factors in Georgia’s failure to meet its mental health workforce needs, said Caitlin Hochul, Inseparable’s senior vice president for public policy.
Equity laws require that mental health providers with the same education as physical health providers receive comparable pay for the service they provide. But, in Georgia, physicians can earn 70 cents or less for every $1 earned by physician assistants.
Additionally, the state meets only 43% of mental health care workforce needs, the report states.
“A real opportunity is for insurance companies and their health plans to pay mental health providers a comparable rate to physical health providers and make sure there are real enforcement mechanisms in place,” she said.
Mental health care and substance use disorder treatment providers negotiate discounted rates with insurance panels so clients can access covered services. But more and more, licensed professional counselors who run practices like Tracy Hooper say the business model isn’t viable.
When Hooper called an insurer about her contract, company representatives sent her around in circles, forcing her to spend several hours of unpaid time trying to recover the missing payment that was deducted from her paycheck.
“The people who make the decisions are not the ones who answer the phone,” she said.
In many cases, mental health professionals are undervalued by insurance company policies, which exclude them from the insurance network, Hochul said. Then, people have to go out of network to find care, which makes costs more expensive and ultimately leads to more people forgoing care altogether, Hochul said.
Hochul said more could be done to strengthen equal enforcement mechanisms and ensure greater oversight, including making sure insurance companies publicly and frequently report the number of providers in their networks.
“Right now, there are ghost networks all over the country, where you have provider directories that are very outdated,” Hochul said. “You have providers who have left the field years ago or sometimes are no longer alive and yet they are still in these guidelines to make it look like your insurance plan has multiple providers when in fact they don’t.”
Senate Bill 131 creates an Equitable Enforcement Review Panel to hold insurance companies accountable when mental health services are not equitably covered. That includes when patients can’t find an in-network provider, said Roland Behm, one of the founders of the Georgia Mental Health Policy Partnership.
“What we need is law enforcement—and what we especially need is to make sure that individuals who need medically necessary mental health care have access to that care and are not denied, delayed, or given less.
This story comes to Current GA through a reporting partnership with GPB News, a nonprofit newsroom covering the state of Georgia.
GPB Health Reporting is supported by the Georgia Health Initiative. Georgia Health Initiative is a nonpartisan, private foundation that promotes innovative ideas to help improve Georgia’s health. Learn more at georgiahealthinitiative.org
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