BY TIM BONFIELD
The Cincinnati Enquirer
In addition to dropping 25 medical specialists, Anthem Blue Cross & Blue Shield has decided to dump about 120 psychiatrists, psychologists and clinical social workers from its managed care plans.
The mental health cutback would take effect Aug. 31 for people covered by Anthem's Community Choice and Community Preferred plans.
The cutbacks have stunned many local providers, said Dr. Kathy Myszak, president of the Cincinnati Academy of Professional Psychology. According to Dr. Myszak, Anthem's move would eliminate nearly a third of its participating psychologists in Cincinnati and Dayton. Meanwhile, similar cutbacks are happening in Columbus, Toledo and other Ohio markets, she said.
Psychologists and social workers say forcing clients to switch therapists is even more disruptive to care than making patients switch medical doctors.
"I have four patients that will be affected. Two of them have very serious problems," said Jessica Murdaugh, a Cincinnati clinical social worker dropped by Anthem. "It took a long time for these clients to start building toward recovery. You stop two-thirds of the way along, and you can lose everything."
The mental health changes are part of a series of recent cost-cutting moves at Anthem -- a health insurer that covers more than 4 million people in Ohio, Kentucky and Indiana.
Wednesday, local doctors revealed they are among 25 oncologists, surgeons and other specialists to be dropped effective Sept. 14. Earlier this month, Anthem announced plans to slash 300 to 400 management jobs.
In May, Anthem decided to drop more than 20,000 rural Ohio residents from its Medicare HMO.
Anthem officials confirmed a cut in its mental health network but say the decisions were made by Greenspring Mental Health Services, a national company that Anthem contracts with to provide mental health services to its members.
"We trust them to make the right decisions," said Paul Beckman, chief executive of Paragon Health Systems, a 2-year-old company that manages Anthem's health plans in Greater Cincinnati.
Paul Krippenstapel, Greenspring's local executive director, was unavailable Thursday. Pam Shapiro, director of provider relations, referred calls for comment to the company's public relations staff in Maryland, who also were unavailable Thursday.
Mr. Beckman said the cuts would affect 280 Anthem members, seen by providers who see relatively few Anthem patients.
He said he did not know how many mental health providers would be left on Greenspring's network.
While some of the dropped providers who contacted The Cincinnati Enquirer -->acknowledged they see very few Anthem patients, others said they will be hit so hard they may have trouble staying afloat. "More than 25 percent of my practice was with Anthem-Greenspring," said a clinical social worker who asked not to be identified because she fears her comments would hurt a pending internal appeal.
"Dealing with the insurance companies is getting more difficult all the time. But I've never been cut like this before. It's a major impact on my business, and I'm really not sure what I'm going to do."
Anthem's move is the latest in a long line of mental health cutbacks linked to the growth of managed care health plans.
The transformation of mental health services has been happening for several years, resulting in the near-complete elimination of inpatient mental health care in favor of outpatient counseling -- even for many people with severe mental disorders. In Cincinnati,
the changes have included the 1994 closing of Emerson A. North psychiatric hospital, deep cutbacks of psychiatric wings at other local hospitals, the closing of the state-run Rollman Psychiatric Institute, reduced services at the state's Pauline Warfield Lewis Center, and the December 1997 merger between the West by Northwest mental health agency and the Talbert House substance abuse center.
