Staff Writer, MedPage Today
That was the question posed by a group of physicians in Boston who had found difficulties in providing psychiatric referrals for their patients.
So they undertook a "simulated patient" study, telephoning all 64 Blue Cross Blue Shield in-network psychiatric facilities within 10 miles of the center of Boston, according to Rachel Nardin, MD, of the Cambridge Health Alliance in Cambridge, and colleagues.
This summary article can be found here.
The original article in the Annals of Emergency Medicine can be found here.
The article concludes:
"Although there are many contributors to the inadequacy of our mental health system, managed care has hit psychiatric services hard. Private insurers aggressively constrain patients' access to services by stringently limiting provider networks. As our study shows, this is often covert; insurers provide lists of in-network providers, but most are unavailable. Reimbursements for psychiatric services are far lower than for other types of care, so institutions frequently restrict access as stringently as possible, often, as in our study, by requiring that a patient have an in-system primary care provider (even though the insurer requires no referral). Many private practitioners refuse to accept insurance payments altogether. Improved reimbursements for psychiatric care will be an important step in reducing the barriers to care experienced by patients with severe depression."
