Health care funding could hurt mental health

Community Reach breakfast warns of Medicaid funding changes

Posted 12/5/18

Steps to streamline Colorado’s health care infrastructure have managed to make it more difficult for mental health care providers, Community Reach CEO Rick Doucet warned a Westminster crowd at a …

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Health care funding could hurt mental health

Community Reach breakfast warns of Medicaid funding changes

Posted

Steps to streamline Colorado’s health care infrastructure have managed to make it more difficult for mental health care providers, Community Reach CEO Rick Doucet warned a Westminster crowd at a Nov. 28 breakfast.

Doucet said that the state Office of Behavioral Health adopted a new policy beginning in July that reorganized how mental health care providers are repaid by Medicaid, creating seven funding regions where four existed before. The new policy brings mental health care providers in line with other medical health care providers, part of the broader state Department of Healthcare Policy and Financing changes that began in 2016.

The changes to Medicaid repayments and to crisis services were all meant to improve how medical and mental health services are provided to the state’s poorer residents, but Doucet said they’ve managed to add a level of bureaucracy and confused patients.

“The proposed changes put administrative convenience over services and we don’t support that,” Doucet said.

Doucet spoke to a group of mental health professionals and state and local municipal officials at the Community Reach 2018 Legislative Breakfast at the Westminster Marriott.

The state changed the way behavioral health is funded in July, adopting a new model based on Regional Accountability Entities. These are groups meant coordinate and manage benefits for Medicaid recipients, the public assistance program for needy Americans.

One goal was to manage physical, medical care alongside behavioral and mental health services, Doucet said.

“The intended goal was to increase integration and streamline access,” Doucet said. “Unfortunately what it’s done is create barriers.”

For example, Doucet said that before the changes, residents determined which Medicaid region they belonged to based upon their address. Residents of Adams County received their benefits through a group called Colorado Access while residents of Jefferson County received service through the Colorado Community Health Alliance.

That changed in July. Now, the doctor or clinic’s location determines which region pays — not the patients’.

“Many consumers got confused,” he said. “They were sitting in a waiting room wondering what was going on. Some were attributed to the wrong doctors and some even lost their Medicaid completely because the system glitched them out. Others had Medicaid, but no mental health benefits.”

It’s created confusion for mental health providers, like Community Reach. Before, Doucet said his group would provide services to anyone, worrying about getting paid later on. Now, since the Regional Accountability Entities are in-charge, groups like Community Reach have to negotiate new contracts with each entity.

“Many of these entities are insurance companies and with seven insurance companies every company wants to do things their own way,” he said. “Some of us don’t have contracts with most them yet.”

Doucet said Community Reach was unable to negotiate a contract with Colorado Community Health Alliance — the entity that serves Jefferson, Boulder, Broomfield, Gilpin and Clear Creek counties — until September.

“They wanted to pay us less than our costs and we can’t stay in business that way,” Doucet said. “However, we’ve been providing services because we had to since July. But we have not been paid.”

Other improvements meant to be part of the system have not happened, he said. It was meant to help child welfare agencies, police, the court system and mental health agencies work together.

“The Regional Accountability Entities have not even looked at that,” he said. “They were also going to pay for this by having savings due to integrating substance abuse services but that’s not even on the table now.”

He urged elected officials, policymakers and members of the community to keep a close eye on the system.

“We urge community members to make sure that they do what they can to hold each entity accountable to program values and promoting health in all of our communities and that they work with us to fix what is broken now,” he said.

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