Even as Mental Health First Aide training sweeps the nation to help moms, dads, teachers and youngsters spot the signs of depression, there remains a shortage of treatment options. Telepsych has helped, but has mostly gained a footprint in the commercial population. So insurers responsible for Medicaid patients are trying to respond with other ideas.
So I called my PCP the other week to make an annual appointment and was told the wait time would be 3 months. No wonder urgent care has seen such high demand for physicals! But what if a patient suffering from anxiety or depression had to wait this long? One health plan in California is looking for new ways to try and bridge this gap.
L.A. Care Health Plan, a Medicaid managed care plan serving 2.2 million members in LA County, is trying to bridge the gap, providing 5 clinicians who work in primary care settings a tuition free psychiatry fellowship at UC Irvine/UC Davis this year. This is the second year that L.A. Care Health Plan awarded scholarships. The program is designed to prep PCPs to diagnose and treat common psychiatric conditions such as anxiety and substance abuse disorders. It’s one of several initiatives to help alleviate some of the bottlenecks to behavioral health specialists.
Dr. Michael Brodsky, Medical Director for Behavioral Health at L.A. Care Health Plan, told us that access issues to behavioral healthcare are often made more difficult for Medicaid beneficiaries due to” a limited pool of behavioral health providers, plus people can’t take time for appointments…so we hope to center some of the mental health treatment in PCP settings.”
L.A. Care Health Plan also recently expanded its loan repayment program to include psychiatrists employed in primary care settings. Funds can be used for salary, benefits, and other subsidies to help recruit physicians to programs that serve patients in the safety net. As of October 1, 2019, contracted entities may request up to $125,000 per provider, which can also include pediatricians, OB/GYNs, and family and internal medicine physicians. No other specialists besides psychiatrists in primary care settings are eligible for this funding, highlighting the importance of this group.
Dr. Brodsky is also interested in more co-location of psych and primary care. It will be interesting to see how successful these programs are as new delivery models like telepsych emerge as popular and effective, and as more insurers take full responsibility for managing behavioral health benefits. -LS