Single Session Therapy Follows Rate Cut
New health insurance policies will pay some therapists and psychologists a lower rate for 60 minute sessions. This may have an effect on patients - potentially leaving some to stop taking insurance or changing availability. One policy – reportedly set to take effect in July affects at least one Aetna network – will reduce the payment level to what would essentially be the 40 minute session. It’s a small but meaningful difference that could be a 25-33% drop in payment. Other insurers are reportedly lowering the payment or outright denying the payment based on belief the 60 minute session itself isn’t medically necessary.
Will this impact the ability for mental health therapy groups to recruit therapists? Probably not. But their ability to recruit psychologists is likely affected. Psychologists who do cognitive behavioral therapy rarely take insurance and often cost people much more per session, like $200-$400.
The insurers have a point to some degree here - what’s necessary, for how long, at what cost, given the sheer demand in this country for mental health care. Is the payment justified for such a long period, like 6 months or more, particularly without progress.
The policies come as these insurers are also promoting an alternative called single session therapy. This is a “utilization management” strategy “to sustain benefit” – as single session therapy can be delivered digitally/virtually at low cost and less overall visits.
44% of health insurers in our poll say they will adopt or promote a similar strategy at some point. It’s threat of completely replacing more ongoing care is low but these changes signal insurance and employer plans to reset the rules on mental health therapy.
The impact is ultimately on consumers and families needing the care. The more acute or serious the condition or diagnosis, the potential impact is likely less. But for the vast majority of people with mental health challenges that fall in the murky middle - perhaps undiagnosed but still real, there is likely more cost to access care, or less care to access.
Insurers we spoke to who are implementing or considering the single session therapy policies like the concept.
“It’s not ongoing care, it’s acute, but the session is designed around a single issue – fits unmet need,” a source said.
“It’s a lot like how we think about other diagnostics like lab and x-rays – it’s diagnostic plus a recommendation to the patient – we think 75% or more of mental health needs by our members could be addressed with this”
There is still a question about the efficacy and role of these sessions but they will gain popularity at least with employers and insurers trying to keep the benefit going.