Medicaid, which is Badger Care in Wisconsin, is the most important source of funds for mental health services. Private insurance companies are second.
State governments set reimbursement rates for the people and institutions that provide those services. Rates in Wisconsin are among the lowest in the country, meaning that many mental health professionals and institutions can not afford to provide care or find it more profitable to work only with private insurance companies and Medicare. The result can be limited or no access to mental health care for Badger Care recipients.
Click here to read an excellent story about the debate between a state senator and the WI Department of Health Secretary Linda Seemeyer about raising those rates.
Here are some excerpts from reporter Keegan Kyle’s article.
“Department of Health Services Secretary Linda Seemeyer repeatedly ducked requests to state a position on hiking Wisconsin’s rates, which are among the lowest in the nation.”
“A hike in Medicaid reimbursement rates for mental health providers wasn’t included in Walker’s proposed state budget this year, and legislative leaders haven’t been confident about boosting rates, citing competing budget priorities.”
“At the March 29 budget hearing, Seemeyer first told Sen. Jon Erpenbach, D-Middleton, that the state has been “trying to look at” rates for mental health services. Then she deferred rate hike decisions to state lawmakers. Then she said more study of rates was needed and suggested using a “pay-for-performance” system to reward providers who produce results. Asked if higher rates would help expand treatment services, she said, ‘Perhaps.'”
According to a video of the testimony accompanying the article, reimbursement rates for counseling in Wisconsin are $32/hr, as contrasted with $70/hr in Minnesota and $65/hr in Iowa. The Department of Health returned $330 million to the General Fund .
UPDATE: At an event sponsored by Wisconsin Health News in early June, Sen. Alberta Darling, co-chair of the Joint Finance Committee, said. “Would we like to give personal care workers more? Of course we would. But we cannot at this time. … I think provider rates in general for Medicaid are a huge issue. We’re, I think, at the bottom if not second from the last. Our provider rates are not good enough and it’s going to be a challenge significantly in the years coming up.”
UPDATE: In July 2016, the Dane County Department of Human Services convened a meeting of contracted providers for behavioral health services to discuss issues and opportunities for collaboration. Medicaid reimbursement rates was the top issue mentioned by DCHS. Others were acceptance of new Medicaid patients by psychiatrists and some therapists and access to prescribers.
UPDATE: Here is an excerpt from the Kids in Crisis/Legislative Action Tracker article that was part of a series by USA Today-Wisconsin (June 2016)
There is evidence that Wisconsin’s Medicaid reimbursement rates – among the lowest in the country – are shutting children out of accessing outpatient behavioral health care and leading to higher costs associated with emergency psychiatric care.
A report by Milwaukee’s Public Policy Forum found that in Milwaukee County, low reimbursement rates were stopping mental health providers from accepting Medicaid patients. A 2014 survey by the Wisconsin Statewide Medical Home Initiative found that only 20 percent of Wisconsin pediatricians said they could find therapists when needed for their patients on Medicaid, and just 5 percent could find psychiatrists for patients on Medicaid.
UPDATE: (Aug 23,2017) New Richmond News reports that “In 2014-15, long-term care facilities in Wisconsin reported a $331.8 million “Medicaid deficit.” The deficit is due to the low reimbursement rates for long-term care services. Click here to read “A Never Ending Death Spiral: SV Health and Rehab Faces Closure.”
UPDATE: See “Walker Raised Medicaid Reimbursement Rates for Mental Health and Substance Abuse Providers” on this blog for recent information.