Health Care

JoCo mental health experts say they can’t meet demand till private insurance pays more

Johnson County mental health officials — facing what they say is the highest suicide rate in any county in Kansas — told U.S. Rep. Sharice Davids on Wednesday they need private insurers to pay more for treatment, especially outpatient care.

Erin Dugan, the president and CEO of the KidsTLC treatment center in Olathe, told Davids that Medicaid pays more for those services than the private sector — something that’s almost unheard of in the physical health realm.

“You cannot even break even in this industry (on private insurance rates), and as a nonprofit that’s all we want to do. We don’t want to make money,” Dugan said. “But the reimbursement rates for preventative, early, low-intensity level mental and behavioral health is awful.”

Medicaid is often the lowest payer in physical health care, with private insurance offering much higher reimbursements to hospitals and other providers.

But in mental health that’s flipped, Dugan said.

Davids, a freshman Democrat, visited KidsTLC on Wednesday as part of a mini listening tour on mental and behavioral health issues in her district, which includes Johnson and Wyandotte counties.

The Star reported earlier this month that the entire Kansas City area is seeing a spike in childhood mental health issues, something Davids referenced in her discussion with KidsTLC officials.

“Frankly I think a lot of people are scared because of what’s going on with our youth and self-harm and suicides that have been going on,” Davids said.

She said that the community seems to be growing more comfortable talking about mental health issues and that the stigma surrounding them seems to be breaking down.

U.S. Rep. Sharice Davids interacts with some of the residents of the KidsTLC inpatient treatment program during a visit Wednesday. Andy Marso

Davids was also scheduled to host a roundtable discussion on mental health at 9:30 a.m. Thursday at the Roeland Park Community Center.

One of the panelists, Johnson County Mental Health Director Tim DeWeese, said he planned to bring up private insurance reimbursements at that meeting as well.

He said Johnson County already has the highest suicide rate in the state, and the county is seeing a 20% increase in calls to its emergency crisis line.

DeWeese said one thing Davids and the rest of Congress can do to improve the system is to add more teeth to parity laws that were supposed to make sure that insurance companies provide the same coverage for mental and behavioral health care as they do for physical ailments.

The laws have been on the books for years, but DeWeese said they haven’t been enforced.

“By law they’re supposed to,” DeWeese said. “Bipolar depression should be treated no different than heart disease. But the problem is, it is.”

DeWeese said Davids’ push for Medicaid expansion in Kansas is appreciated, but won’t be enough to shore up the system without change in the commercial insurance realm.

DeWeese said when people who have private insurance are denied coverage for mental health care, they end up having to use safety net providers like the county health department, that are already stretched thin trying to fill the needs of the uninsured.

“People are saying, ‘Well, I have insurance’ and we’re saying, ‘We understand that but your insurance company won’t authorize payment or won’t authorize this type of service,’” DeWeese said. “There may be enough providers in our community if insurers would pay a healthy rate and they would authorize services.”

Until then, DeWeese said it will be difficult for Johnson County to meet the growing demand for services as people get more comfortable admitting they need help.

Dugan said the low reimbursement rates for outpatient care make it difficult for families to find help until they face a crisis that requires inpatient care.

KidsTLC also provides that, but would rather avoid it through earlier intervention if possible.

“Even though we’re saying mental health should be just like physical health and all that stuff, the payers aren’t coming around,” Dugan said. “So as we’re talking about it more, people are more aware, they want appointments, they want to come in and it’s hard to find therapists that can even make a living wage.”

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Kansas City Star health reporter Andy Marso was part of a Pulitzer Prize-finalist team at The Star and previously won state and regional awards at the Topeka Capital-Journal and Kansas Health Institute News Service. He has written two books, including one about his near-fatal bout with meningitis.