A Study of Clinicians’ Experiences Providing Mental Health Care in Massachusetts
From the report's introduction:
The University of Massachusetts Donahue Institute (UMDI) was retained to develop, implement, and analyze the results of a survey of private practice clinicians throughout the Commonwealth of Massachusetts as part of a broader CliniciansUNITED effort to examine policy impact on the affordability and accessibility of mental health care in Massachusetts. CliniciansUNITED is a multidisciplinary group of behavioral health clinicians who are associate members of the Massachusetts Human Service Workers Union, SEIU Local 509. The project was conducted over a seven-month period, from May 2014 through December 2014.
In 2012, the Massachusetts legislature passed Chapter 224 of the Acts of 2012, “An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation.” This next phase of health care reform was designed to control health care cost growth through a number of mechanisms, including the creation of new commissions and agencies to monitor and enforce the health care cost growth, adoption of alternative payment methodologies, increased price transparency, investments in wellness and prevention, an expanded primary care workforce, a focus on health resource planning, and further support for health information technology, among others. Most relevant to independent behavioral health clinicians was the move toward integrating physical and behavioral health services through the creation of additional accountable care organizations (ACOs) and patient-centered medical home systems. Given these reforms and the rapidly changing landscape in which independent clinicians must operate, CliniciansUNITED identified the need to gather information about what private practice mental health clinicians and their clients are facing in the current treatment environment. This survey was commissioned to address this need.
The overall goal of the survey was to document the broad range of experiences private practice clinicians have when engaging with insurance companies and the health care payment system. In particular, the survey attempted to document the issues clinicians throughout the Commonwealth encounter when working with insurance providers as members of insurance panels, including dissatisfaction with reimbursement rates, attempts to join panels, authorization of services, and retroactive claims denial provisions (clawbacks). The survey also assessed the extent to which clinicians feel informed about health care payment changes connected with payment reform in Massachusetts and reforms associated with the Affordable Care Act. Finally, the survey documented demographic and professional characteristics of clinicians and assessed the extent to which the CliniciansUNITED campaign is focusing on the issues most concerning to private practice clinicians.