While a workforce shortage is often blamed, insurance company practices are driving therapists into private practice, according to The Workforce Report: Bridging the Mental Health Care Gap report from Inseparable, a group advocating for mental health access nationwide.
Low pay, high education costs and provider burnout are key factors behind Georgia’s failure to meet its mental health workforce need, Inseparable Senior Vice President of Public Policy Caitlin Hochul said.
Parity law requires that mental health providers with similar education to physical health providers earn comparable wages for the service they’re providing. But, in Georgia, therapists can earn 70 cents or less for every $1 earned by a physician’s assistant.
On top of that, the state only meets 43% of its mental health care workforce needs, the report said.
“One real opportunity is requiring insurance companies and their health plans to pay mental health providers a comparable rates to physical health providers and making sure that there’s real enforcement mechanisms,” she said.
Mental health care and substance use disorder treatment providers negotiate discounted rates with insurance panels so that clients have access to covered services. But more and more, licensed professional counselors running practices like Tracy Hooper are saying the business model is unreliable.
When Hooper called one insurer about her contract, the company representatives sent her in circles, forcing her to spend hours of unpaid time trying to recoup lost payment that had been clawed back from her paycheck.
“The people making the decisions aren’t the ones answering the phone,” she said.
In many cases, mental health professionals are undervalued by insurance company policies, Hochul said, which drives them out of insurance networks. Then, people have to go out of network to find care, which makes costs more expensive and that, ultimately, leads to more people forgoing care altogether, Hochul said.
Hochul said more can be done to strengthen parity enforcement mechanisms and ensure substantial oversight, including making sure insurance companies are publicly and frequently reporting the number of providers in their networks.
“Right now, there are ghost networks across the country, where you have provider directories that are extremely out-of-date,” Hochul said. “You have providers who left the field years ago or, sometimes, are no longer living and yet they’re still on these directories looking like your insurance plan has a lot of providers when, in fact, they don’t.”
Senate Bill 131 creates a parity enforcement review panel to hold insurance companies accountable when mental health services are not covered equitably. That includes when patients cannot find a provider in network, said Roland Behm, one of the founders of the Georgia Mental Health Policy Partnership.
“What we need is that statute enforced — and in particular, what we need to ensure is that individuals who need medically necessary mental health care have access to that care and are not denied, delayed, or given something less than,” he said.
This story comes to The Current GA through a reporting partnership with GPB News, a non-profit newsroom covering the state of Georgia.
GPB’s Health Reporting is supported by Georgia Health Initiative. Georgia Health Initiative is a non-partisan, private foundation advancing innovative ideas to help improve the health of Georgians. Learn more at georgiahealthinitiative.org
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Type of Story: News Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources.