A previous draft of this article was first posted on Feb 23, 2017. This post has been updated to reflect the final version of the article.
By Samantha Slaughter, Psy.D.
After reading the APAPO article Considering Medicaid: Why Participate by Rebecca Clay, I decided to add to it with an article focused on Washington. In Washington State, expansion of the Medicaid (or Apple Health) program under the Affordable Care Act has reduced the uninsured rate significantly. In King County, for example, the uninsured rate is 7.7 percent, half of what it was in 20131. According to the Seattle Times, more than 600,000 residents of Washington gained coverage through the Medicaid expansion1. Most if not all of the major agencies and hospitals in Washington are in-network with Apple Health plans, allowing patients to access most aspects of healthcare. However, when referrals to non-agency providers are necessary, they can be difficult to find. There is a dearth of providers in private practice on Apple Health plans. I spoke with Cara Dalbey, PsyD, Director of Behavior Health at Healthpoint. Healthpoint is a network of 12 health centers with integrated behavioral health providers and has locations throughout King County. When asked about finding referrals for their Medicaid clients who need long-term treatment, Dr. Dalbey said, “We’re often at a loss. It’s significantly difficult for our Medicaid patients.”
I encounter behavioral health providers frequently who hesitate to join the networks of the Apple Health plans. They give various reasons for not participating in Apple Health – low reimbursement rates, paperwork, possible severity of mental health issues. However, there are several reasons you should consider when deciding if you want to become an Apple Health provider. Reasons for accepting Medicaid clients given in the APA article are embracing social justice, growing your practice, enriching your training, and advocacy. The social justice aspect is the main reason I joined the networks of the Apple Health plans. In the APA article, the issue of privilege is mentioned. I believe that all people who want mental health treatment deserve access to care. In addition, they deserve the same access to care that a person with an employer or other insurance plan has. By being an Apple Health provider, I ensure that all potential clients who call me have equal access no matter their economic privilege.
Growing your practice is another great reason to become an Apple Health provider. At my group practice, we receive five or more calls/emails a week from Apple Health subscribers looking for services. One could easily fill openings with Apple Health clients and never worry about having a less-than-full practice again. While reimbursement rates are lower than standard insurance plans, there is a reimbursement range which allows a provider to choose to join the panels of only those plans who reimburse the highest if desired. If you are early in your career and just starting your practice, consider joining one or more Apple Health networks to bring in revenue while you network and grow. I have not heard of a single Apple Health panel being closed, so you will be able to join and to start seeing clients relatively quickly.
As far as elevating your training, I can vouch for the enrichment of my practice and knowledge base by working with clients with Apple Health. I have an appreciation for the depth of resilience of these clients. They are facing challenges that my clients with more economic and social privilege do not, and yet they continue to work hard and to strive for behavioral health improvements with no less devotion than other clients. I am a more creative and flexible psychologist because of them.
Finally, the APA article gives advocating from within as a reason to join Medicaid. I have not needed to advocate for my Apple Health clients on a systemic level, but that will likely change as the Affordable Care Act is altered at the federal level. Those changes will impact our clients in Washington. I will have a stronger voice when talking with politicians about our Apple Health plans because I am an in-network provider.
Interested in becoming a Medicaid/Apple Health provider? I hope so! There is a two-step process here in Washington. Before you can join one of the Apple Health plans as a provider, you must first be a provider with the Health Care Authority (state-run Medicaid). I am not sure why this is necessary, but the Apple Health plans can no longer accept providers onto their panels without this step.
Here is the information you need:
Step 1: Become a Medicaid provider through the Health Care Authority (HCA). You can do this online – http://www.hca.wa.gov/billers-providers/apple-health-medicaid-providers/enroll-provider. The Provider Enrollment department can be reached at 1-800-562-3022 x16137.
Step 2: Choose one or more Apple Health plans to join and contact their provider relations departments for instructions on how to become an in-network provider. There are five Apple Health insurers in Washington. The provider relations contact information for each is listed. Luckily, most if not all of the plans use OneHealthPort for credentialing, so you can apply to more than one plan with one application.
Community Health Plan of Washington:
Coordinated Care of Washington:
Molina Healthcare of Washington:
United Healthcare Community Plan:
The APAPO article is the first of six articles about Medicaid. Stay tuned for the rest of the series and my Washington-focused articles.
Samantha Slaughter, PsyD is a business consultant and the CEO of Integrative Psychological Services of Seattle (www.IntegrativePsychologySeattle.com) as well as a licensed psychologist. She is the Chair of WSPA’s Advisory Committee, serves as the APA Federal Advocacy Coordinator, and is a past WSPA Board member. Questions and/or comments about this article can be emailed to her directly at Samantha@IntegrativePsychologySeattle.com.