- Optum/ UHG keep tooting their ho-n about providing and investing in MH yet they do these sneak attack layoff/ firings when they know months in advance they plan to make changes. They then leave the skeleton crew to pick up 3 other people's tasks, while pounding metrics. They bought out AbleTo, Blend, and refresh MH and underpay the therapists. They barely have in house EAP specialists but offer EAP anytime there are hard changes. Employees are in a constant state of anxiety and central nervous system kicked off line.
- The current BH model at OAH makes no sense, it really never did under LM. They wants BHCM's to have a caseload of 100-125 when private practice is around 30 clients. They provide no exclusion criteria, so BHCM's have a full caseload while trying to constantly put out crisis fires as pts call into LM1 threatening su----e/ homic--e/ panic attacks etc and the staff doesn't understand MH, trauma and personality disorders at all. They want BH to "fix" the problem. Well, when we have a 70-100 caseload minimum dealing with severe trauma, PTSD, PD, Bipolar etc that's a little tricky. The new model seems to reduce BH staff and appears to separate the BHC and BHCM more.
- They tend to give 2 week notices for layoffs/ restructure, but anything less than 30 days for MH termination could construe abandonment and must be handled delicately or the clinician can be sued, lose their license or incur board fines, etc
- BHC and BHCM's continue to leave and they do not backfill the roles. Either they want them all to leave so they don't have to pay severance, they want a skeleton BH crew only, or they're trying to figure out some type of restructured way to make money and if they do then they might fill positions.
- The new model has the SW manager, SW and BHCM under the HSM....what a slap in the face! SW managers and BHCM's are LCSW's. A LCSW is an independent practitioner with generally more than 3,000 clinical client therapy hours and supervision hours above a Master's degree. IMO, they are a higher level than a HSM but for sure not under their level. HSM's are usually MSN or MBA, neither of which know anything about BH or SW. So when problems arise they will back the nurses....always. It really seems like they did this to get people to take a hint and leave, and trust me they will.
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CMS is updating its criteria on whom it may concern can be considered a mental health provider. This allows medical providers and RNs to help fill the void in mental health providers. If a company can fill positions with staff, they can pay a cheaper wage than they will.
@1tjo+1sl8FVRe That is so true that affordability and transportation are 2 huge barriers if they discontinue BH services in house for OAH. BHCs don’t do touches. They go IOC notes, but it isn’t clear on that slide about 1.3 touches who it’s talking about. Then they have the BH case manager listed separately on some slides and not others. There is a BH case manager job posted for OAH and it said it can be a LMSW or even nurse I think, but it was where you completed an assessment and then determined level of care and referred them to that. It makes me wonder if that’s the direction they’re going.
The BH and SDOH needs of the company are significantly increasing but the model as it stands will not create much of an impact in the SNP patients and many of the now Landmark patients. Telephonic collaborative care can help patients with depression and anxiety but when you get patients with severe mental illness or significant substance use, they require a more hands on approach and frequent touches. Many of these dual diagnosis, younger patients frankly need an ACT team to make a positive impact not to mention insurance plans who actually cover mental health benefits without exorbitant co-payments. People on medicare and Medicaid CAN NOT afford $35 copayments for weekly therapy and med management. UHG needs to seriously look at their benefit options within their plans if they think we can save them money because the SDOH needs are significant and the acuity is increasing dramatically. And I am not sure what the new model is just yet but pretty sure the 1.3 BH touches per referral on the slide they keep showing is not going to a damn thing.
The BH business is growing, but they lay off their already overworked staff. Genius.
None of the RNs in my market have a masters degree including our director of clin ops. In the medical setting, LCSWs are treated like they are akin to RNs because they are both licensed. Social work has a long way to go to get the respect they deserve in the medical setting and that includes their pay.