Regents select Healthnet as new benefits provid

Friday, January 24, 1997

FACULTY:

System-wide change could have negative effects on employee
mental health careBy Hannah Miller

Daily Bruin Contributor

The University of California Regents have initiated a
system-wide change in employee benefits that many caregivers fear
may have negative effects for employees in need of mental health
care.

For UC employees that have selected Healthnet as their benefits
provider, their mental health coverage will be subcontracted out to
another provider, Value Behavioral Health, starting April 1.

The new plan will require all Healthnet-enrolled employees to
disrupt their caregiver relationships and switch to Value
Behavioral’s network, locking UCLA’s Neuropsychiatric Institute
(NPI) and local private practitioners out of the benefits
program.

"I don’t know why the regents did this," said Kathy Bianco,
administrator for UCLA Medical Group. "If someone comes in now with
marital discord or anxiety stress, we can’t just send them to the
NPI anymore. We have to tell them to get a referral."

Referrals will be made through an entirely new process when
Value Behavioral takes over. Patients will be certified for
therapist visits only after using an 800-number operator to explain
why they should have treatment. In the realm of mental health care,
relying on patients to correctly self-report is risky, according to
Dr. Shira Volmer, a psychiatrist in private practice in
Westwood.

"The new system will encourage patients to report their symptoms
in the extreme," Volmer said. "Or they won’t tell the full truth
and won’t get help."

What is still unclear is the reasoning behind the change and,
more specifically, who exactly it is supposed to help.

As Terry Lightfoot, a spokesman for the regents’ office in
Oakland, explained, "The UC medical centers were providing a little
more care than was available through the benefits package."

The Oakland office made this decision because the UC medical
centers were providing a higher level of service than providers out
in the community, Lightfoot added.

Volmer, whose practice was previously a part of the coverage
program, disagrees. "(That explanation) is a joke," she said.
"Although Healthnet said it would only cover crisis care, in
practice that was not so."

Therapists say they are concerned about potential psychological
effects of the switchover on patients.

"I see a lot of patients concerned about this," said David
Feinberg, director for the NPI Outpatient Services and Managed
Care. "We are making every effort that there will be no change in
their therapist, even though it is going to cost us money," he
said.

To maintain continuity, a crucial element in mental health care,
the NPI has tried to plug into Value Behavioral’s network, but with
little success. "There’s no way they’re going to let us sign up,"
said Feinberg. "They say the network is full."

The other five UC Medical Centers, none of which are a part of
Value Behavioral’s network, face similar difficulties in getting
in.

The regents counter that this is not their responsibility. As
Lightfoot put it, "The benefits office can’t design a package based
on getting care to the UC medical centers."

In an effort to stay with their patients, the NPI providers
might contract with another external therapy ‘group’ to continue
seeing them. However, Feinberg worries that this option would
reduce income for therapists because a middleman could take an
estimated 20 percent.

While originally slated for Jan. 1, 1997, no official
notification was ever made to UCLA employees regarding the
switchover by either Value Behavioral, Healthnet or the UC Benefits
Office

Volmer said that she was only made aware of the changes through
a patient’s questions. In response to this initial confusion, the
switchover date was moved to April 1.

Even the extension of the benefits caused disruption, because
many patients had already undergone the process of terminating
relationships with their therapists. This termination process
involves time and energy, licensed clinical social worker Rebecca
Hearst explained.

Individual practitioners in the community say they will be hard
hit when Value Behavioral takes over. Hearst alone estimates that
"more than one-half" of her Westwood practice consists of UCLA
employees.

The regents’ failure to inform employees of the changes has also
troubled many people. Every November, UC employees choose an HMO
for their benefits coverage. Although the current change in policy
was negotiated before last November’s open enrollment, UC employees
were not notified when they chose between Healthnet and other
HMOs.

According to the UCLA benefits policy, the mental health care
coverage is still the same ­ 20 visits with a $20 co-payment
per visit. However, Feinberg says he is skeptical that the level of
care will be maintained.

"UC benefits shouldn’t have gone to Value Behavioral," Feinberg
said. "They have no concept of the effects of this change."