Outdated Doctor Lists Still Make It Hard to Access Mental-Health Services

Andrew Kitchenman | September 16, 2014 | Health Care
Inaccurate contact info and in-network limits remains problems despite new federal laws bolstering behavioral-health coverage

Carolyn Beauchamp, president and CEO of the Mental Health Association of New Jersey.
Insurance is supposed to cover mental-health treatments, just as it pays for other types of healthcare.

But despite new mandates in federal law, including the Affordable Care Act, outdated information still makes it hard to access mental-health services — right down to simple things like insurers’ websites containing old and inaccurate listings for psychiatrists.

Contact information for 33 percent of a random sample of psychiatrists on insurance company websites was inaccurate, according to a random sampling done by the Mental Health Association of New Jersey in the spring of 2013. Those inaccuracies ranged from listing providers who were no longer in the insurer’s network to wrong phone numbers for other providers.

The nonprofit association also found that only 51 percent of psychiatrists listed on insurance sites were actually taking new patients, while only 25 percent could offer an appointment within two weeks.

“If we can put ourselves in the place of someone who’s suffering and trying to get help and can’t find it, and feels that there is not an answer – there should be nobody in that situation,” said MHANJ President and CEO Carolyn Beauchamp. “We have to find ways to solve this.”

The problem is compounded by the fact that many psychiatrists don’t accept private insurance, while Medicaid reimbursement rates are too low to attract many doctors.

But the situation may be improving. A state regulation that went into effect in January requires insurers to contact providers who haven’t filed a claim in one year to check whether the provider is still in the insurer’s network. The regulation also requires insurers to quickly update their websites when they receive new information from providers.

“The health plans have to make this clear as quickly as possible, so the patient knows how to get help if they have trouble finding someone in network,” said Dr. Linda Gochfeld, a psychiatrist and a member of MHANJ’s public policy committee. “A life may depend on it.”

Wardell Sanders, president of the New Jersey Association of Health Plans, said insurers have made progress over the past year in improving their online directories.

He noted that insurers must strike a balance between making sure information is current and not being so aggressive that they alienate providers.

He said insurers have been working with the Mental Health Association of New Jersey to ensure that patients have access to psychiatrists. For example, if someone can’t find a provider in an insurer’s network, they can receive an “in-network exception,” in which the insurer pays for an out-of-network provider.

At a press conference yesterday announcing the report’s findings, several people pointed to other factors that limit access to mental and behavioral healthcare.

While federal and state governments have taken steps in recent years to put insurance coverage of behavioral health on the same footing as other healthcare, many psychiatrists still don’t accept private or public insurance. This traces back to a time when many health plans didn’t cover most psychiatric treatments.

Both Sanders and Beauchamp added that everyone involved in behavioral health should work to remove the stigma involved with seeking behavioral healthcare.

“Sometimes folks don’t want to shop (for a psychiatrist), there’s an embarrassment factor, a stigma factor, and that impedes access to care,” Sanders said.

Beauchamp called on the state to increase funding for preventive behavioral healthcare, saying that could stave off more serious problems. She also called for more transparency related to how many patients are getting behavioral healthcare, and what services they’re receiving, and for the state to document at least once annually that people have adequate access to care.

Legislators from both political parties said they would support efforts to increase behavioral health access, including Sen. Joseph F. Vitale (D-Middlesex) and Assemblywoman Mary Pat Angelini (R-Monmouth).

Angelini, CEO of behavioral health provider Prevention First, said people frequently aren’t concerned about access issues until a family crisis arises. She described the issue as “nonpartisan.”