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Blue Cross Blue Shield's change upsets mental health care providers

Psychologists and other mental health professionals fear many patients' care will be restricted and their own payments will be cut when an outside company takes over behavioral health services for Blue Cross Blue Shield of Florida, the state's largest insurer.

This month, psychologists and others began receiving letters that Blue Cross was terminating their contracts and turning over management of behavioral health services to Kansas-based New Directions Behavioral Health. The move comes as insurers and employers increasingly seek to control escalating health care costs.

The contract terms are sounding alarms in the mental health community.

One provision would prohibit psychologists from referring Blue Cross patients to non-network providers, the Florida Psychological Association told the state insurance commissioner, asking for more time to review the contract.

"This requirement is in blatant disregard of the medical needs of the patient," the association wrote in a letter this week.

Psychologists also are alarmed by plans to reduce their payments by more than 30 percent, one of the largest cuts their national society has seen in more than a decade.

But Blue Cross Blue Shield of Florida says its 4 million members will not see changes to their behavioral health benefits. If anything, the partnership with New Directions "is actually putting greater emphasis on improving member care," said spokesman John Herbkersman.

With greater control over health care costs, Blue Cross members should end up paying less for their insurance coverage in the long run, said New Directions senior vice president and chief marketing officer Griff Docking.

He said New Directions will work to improve how care is coordinated for patients dealing with both behavioral issues and other medical ailments and help them avoid unnecessary repeat trips to a hospital.

Psychologists fear they will have to battle the managed care provider to give patients the treatment they need.

"It puts a handcuff on us as far as the ability to see patients freely and provide the care they need without a third party interfering or dictating what they believe is needed," said Harold Linde, a clinical psychologist in private practice in Tampa.

The changes affect not only psychologists, but other behavioral health providers contracted with Blue Cross Blue Shield of Florida — including psychiatrists and social workers — except for those who are part of multi-speciality groups. The insurers' existing contracts with affected providers expires at the end of November.

"It really looks like a lose-lose type of proposition for the clinicians," said Jim Akin, executive director of the National Association of Social Workers Florida Chapter.

Letitia Stein can be reached at lstein@sptimes.com.

Blue Cross Blue Shield's change upsets mental health care providers 08/12/11 [Last modified: Friday, August 12, 2011 11:43pm]

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