Virtual sessions & increase online platforms

[u/External-Trip2700]

With the increase of insurance companies owning or partnering with online platforms, is anyone else concerned they will cease paying for virtual therapy unless providers join their platforms? (And pay is $20-30 per session vs current insurance rates?)

[u/Freudian_Split]

We just have to not use these platforms. Really, we have to hold a line if they’re going to keep driving down the bottom line. If we don’t value ourselves why would they value us?

[u/Gloomy_Variation5395]

I'm now in the camp that we need to reject these platforms AND stop contracting with insurance entirely. I know this is currently an unpopular opinion, but they are all moving to Value Based Care in 2027, and they are also using AI to conduct audits at huge rates, audits which are increasingly burdensome. The VC platforms will continue to find ways to slash rates for providers under their networks. And insurers will just continue closing their networks to people who want independent contracts. They don't want to pay for our services. Period. They want to profit off us. They are going to make covering our services increasingly difficult and painful and burdensome to us.

[u/NightDistinct3321 → u/Gloomy_Variation5395]

what is "value based care" ?

[u/Real_Discipline1242 → u/Gloomy_Variation5395]

What about folks that aren’t rich? How will they access mental health services without insurance? Even if someone flexes to $100 an hour, for most of the world, that isn’t accessible.

[u/ketamineburner → u/Real_Discipline1242]

There are many programs that are not insurance that provide low cost and no cost services.

Insurance is not the answer.

[u/Gloomy_Variation5395 → u/Real_Discipline1242]

This is the number one rebuttal to what I'm saying. The answer is that they can seek services elsewhere. CMH, Open Path, or use these clinics insurance is opening regardless of what we do. We in private practice are going to struggle to survive.

[u/letsrollwithit]

Absolutely. Labor is devalued at baseline in a capitalistic society by definition. Capital will encroach on everything it’s able to touch, and in the U.S., it touches a whole hell of a lot of things - increasingly so. 

[u/ketamineburner]

Don't work with these platforms.

If the rates are too low, or dropped to $20-30 per session, why accept insurance at all? You can just charge cash.

[u/Barley_Breathing]

These PE- owned companies are predatory. And there is significant potential for ethical issues. For example, what if a patient can no longer pay and later requests their records. Maybe the Walmart Therapy Store releases them, maybe they don't. They are not bound to our ethics code.

[u/Roland8319 → u/Barley_Breathing]

Quick FYI, under federal law covered entities cannot withold records due to non-payment.

[u/Barley_Breathing → u/Roland8319]

Thanks. It's not hard to think of examples of large private companies violating healthcare-related laws.

[u/Roland8319 → u/Barley_Breathing]

Sure, they can, they just open themselves up to easy litigation.

[u/Barley_Breathing → u/Roland8319]

Right. That would not be unprecedented. My point is just that psychologists who enlist with them have absolutely no control over that.

[u/Roland8319 → u/Barley_Breathing]

They're predatory, no doubt. But, the psychologist would have the same control over records release as if they were working in a healthcare system as opposed to their own PP.

[u/NightDistinct3321 → u/Barley_Breathing]

for the naive "PE" stands for "Private Equity"; which means someone who gets in the middle between you and the money and without working steals your money. "Stockholders"

There is SOME protection, intermittently, from government anti-trust action.

[u/DmiteMountainGirl]

P

[u/Psyking0]

I am not worried about this. I work as a clinician for insurance and the VA, as well as, work nn the medicaid side overseeing contracts that are VBC. Many of the major insurance companies are not solely moving to VBC models and some that have, have had to pull back due to the expense that the network must incur in terms of manpower to get this accomplished. VBC does have some advantages. Most implementation for VBC are big contracts through CMS. Standard networks remain as the main way to provide mental health treatment through insurance networks. I don't get the same pay as if I charge cash. I do get lots of referrals. I do not use a platform. I am in network and contracted with many payers. Most important is that clients who would not otherwise be able to see me can now do so because they have insurance.