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SOLDIERS STRUGGLE TO FIND MENTAL HEALTH
THERAPISTS -- Military insurance is cutting
payments
to therapists, on top of already low
reimbursement
rates and a tangle of red tape.
Story here...
http://www.chron.com/disp/
story.mpl/ap/politics/4877244.html
Story below:
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Soldiers struggle to find therapists
By KIMBERLY HEFLING
The Associated Press
WASHINGTON — Soldiers returning from war are finding it more difficult
to get mental health treatment because military insurance is cutting
payments to therapists, on top of already low reimbursement rates and a
tangle of red tape.
Wait lists now extend for months to see a military doctor and it can
takes weeks to find a private therapist willing to take on members of
the military. The challenge appears great in rural areas, where many
National Guard and Reserve troops and their families live.
To avoid the hassles of Tricare, the military health insurance program,
one frustrated therapist opted to provide an hour of therapy time a week
to Iraq and Afghanistan veterans for free. Barbara Romberg, a clinical
psychologist in the Washington, D.C., area, has started a group that
encourages other therapists to do the same.
"They're not going to pay me much in terms of my regular rate anyway,"
Romberg said. "So I'm actually feeling positive that I've given, rather
than feeling frustrated for what I'm going through to get payment."
Joyce Lindsey, 46, of Troutdale, Ore., sought grief counseling after her
husband died in Afghanistan last December. The therapist recommended by
her physician would not take Tricare. Lindsey eventually found one on a
provider list, but the process took two months.
"It was kind of frustrating," Lindsey said. "I thought, 'Am I ever going
to find someone to take this?'"
Roughly one-third of returning soldiers seek out mental health
counseling in their first year home. They are among the 9.1 million
people covered by Tricare, a number that grew by more than 1 million
since 2001.
Tricare's psychological health benefit is "hindered by fragmented rules
and policies, inadequate oversight and insufficient reimbursement," the
Defense Department's mental health task force said last month after
reviewing the military's psychological care system.
The Tricare office that serves Fort Campbell, Ky., and Fort Bragg, N.C.
— Army posts with heavy war deployments — told task force members that
it routinely fields complaints about the difficulty in locating mental
health specialists who accept Tricare.
"Unfortunately, in some of our communities ... we are maxed out on the
available providers," said Lois Krysa, the office's quality manager. "In
other areas, the providers just are not willing to sign up to take
Tricare assignment, and that is a problem."
Tricare's reimbursement rate is tied to Medicare's, which pays less than
civilian employer insurance. The rate for mental health care services
fell by 6.4 percent this year as part of an adjustment in reimbursements
to certain specialties.
Since 2004, Tricare has sped up payments to encourage more doctors to
participate, said Austin Camacho, a Tricare spokesman. In some
locations, such as Idaho and Alaska, the Defense Department has also
raised rates to attract physicians, he said.
"We are working hard to overcome those challenges," Camacho said.
Jack Wagoner is a retired military officer and psychologist and
psychiatrist in private practice who also works for a Tricare
contractor. He told defense mental health board members last December
that in general, Tricare pays "considerably lower" than private health
insurance plans.
According to data from Tricare's Medical Benefits and Reimbursement
System office, Tricare pays mental health providers as much or more than
a corporate plan would pay a therapist for treating a patient — although
in some cases it is lower.
There are different coverage plans within Tricare, and the amount paid
to providers varies by plan, location, specialty and services performed.
Psychologists who treat active duty troops are paid 66 percent of what
Tricare views as the customary rate. So a psychologist eligible for a
customary rate of $120 per hour would be paid $79.20 for the hour by
Tricare, even if the psychologist's standard rate is $150 per hour.
Active duty troops use Tricare Prime, a managed-care option maintained
by private contractors. Their mental health care is free. Guard and
Reserve troops and their families frequently use Tricare Standard, a
fee-for-service plan. They pay an annual deductible and 20 percent of
the amount Tricare pays the therapist.
John Class, a retired Navy health care administrator who now advocates
on health issues for the Military Officers Association of America, said
Tricare Prime contractors insist that the lower reimbursement rates has
made it tougher to maintain a network of providers.
"We are already starting to see the pinch," Class said.
In a limited study by Tricare released earlier this year, about two out
of three civilian psychiatrists in 20 states were willing to accept
Tricare Standard clients among their new patients, the lowest acceptance
rate for any specialty.
Any additional cuts in Tricare payouts could mean that "some really good
psychologists who specialize in this treatment and are experienced will
be seeing less of (military families)," said clinical psychologist
Marion Frank, a widow who is president of the Philadelphia Chapter of
the Gold Star Wives of America, a support group for military widows.
In parts of Montana, some families drive two hours to see a physician of
any kind that will take Tricare, said Dorrie Hagan, state family program
director for the Montana National Guard.
"When you get away from a city of any size then you start struggling for
providers, and they'll tell you flat out it's because of the rate of
pay," Hagan said.
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On the Net:
Defense Department's Mental Health Task Force:
http://www.ha.osd.mil/dhb/mhtf/default.cfm
Tricare: http://www.tricare.mil/
Give an Hour:
http://www.giveanhour.org
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Larry Scott --
