Notes from the meeting of NASW and therapists with Dr. Jeffrey Simmons of BCBSMA, July 23, 2007:
This was called by BC/BS to allegedly allay fears of clinicians facing the newly proposed distribution of lengthy questionnaires (three long pages) to patients, giving patients’ insurer the most thorough information about themselves imaginable, including ethnicity, income, sexual preference. The compliance of patients would be linked to the sum paid to their therapists.
The meeting was conducted by the pleasant, polished, professional business man, Dr. Jeffrey Simmons, MD, Psychiatrist who had studied under Psychoanalytically trained Gerald Adler, but had "decided to choose another path". Present, also was Helen Konecky, (sp?) BC/BS's Provider Relations person.
Representing NASW was Kristina Whitten. NASW had sent out 250 invitations to members. About 25 responded and 20 showed up. Perhaps the fact that it rained quite heavily that day had something to do with it.
At this point I might add my comment that the clinicians who attended made me proud to be one of them, with their insightful examples of ways in which such a proposed program could violate the entire meaning of treatment, show distrust for the therapeutic process and contaminate the relationship. One of the most objectionable ways of doing this, many felt, was by pressuring the therapist because of the salary differential if patients complied.
Dr. Simmons said that, no; indeed. BC/BS had created a new program called :Behavioral Health Measurement Outcome because "studies support" that by outcome measurement "patients get better care" and providers can be shown "how to improve their worth". For example, if patients get a low score suggesting they are at risk "BC/BS moves in to manage". At the same time, Dr. Simmons stressed that data collected in this program will be kept confidential.
NASW, which, traditionally, focuses on working within the business system toward compromise solutions, stressed the aspect of the plan tying fee to therapy as defined by the insurer. Dr. Simmons seemed to be somewhat inclined to considering this with his business associates, but also stated, "The decrease" in therapist's pay "is not a punishment". He said that all preferred providers' rate of pay is going down 6%. but that the therapists who comply with the Behavioral Measure Outcome program will be giving more time and effort to do this and will end up "staying flat" for the extra work.
In response to a question, Dr. Simmons said that as a therapist you cannot join the program and then do nothing about it. If you have ten or more BC/BS patients you will be expected to enlist 60% as signees. If you have five to nine patients, the number is 40%. Zero to five don't have to be included. Patients may even enjoy filling out the forms, Dr. Simmons conjectured, because "sometimes you can say things on paper you can't say face-to-face."
The attendees seemed to me to be leaving in the same disheartened state they were in on arriving, and remarks, overheard on the way out seemed to support this. Dr. Simmons last words were to remind us that managed behavior was now the wave of future psychotherapy and that, not only was BC/BS the last insurer to join the movement, but they were gracious enough to call this meeting and let clinicians speak their minds. "It could be worse," he said. "There can be more Draconian measures."
