I am reporting on reduction of services as well as payment for treatment within the managed care system. As a provider of services I have had my reimbursement reduced and my clients have had their co-payment increased. The net is that I get $5.00 per session less than before April '04. My level of pay for these services is less than half of that of a practitioner who gets paid outside managed care. In addition there is a large amount of ongoing paper work to get approval for services and to get paid.

As users of managed care services I have two situations to report. A teenager I know was recently hospitalized for psychiatric problems. He was given 8 days of service and then discharged. It was determined that he was not a danger to himself or others, although very depressed and quite unmanageable at home and he was sent home with very little treatment. His HMO refused to pay for any more days in the hospital.

Another friend of mine needed a root canal. There are only 4 dentists in his area that take his insurance. They are completely overbooked and there is a very long wait for service both to get appointments and in the office on the day of the appointment.

Membership in these plans is paid for and the members are not getting adequate services. In addition the practitioners are not being reimbursed sufficiently and many leave the panels. Thus reducing availability of practitioners. It does not pay to do this work. At the moment I do psychotherapy because I get a certain amount of satisfaction helping people change their situations, not because it pays enough. I choose my clients carefully to achieve this goal not because I get paid well.

# Posted by Eve Winer on 2/10/05; 6:30:25 PM - --