Apparently a $4 million stick wasn’t big enough to encourage Kaiser Permanente in California to offer residents better mental health care in the state. While Kaiser fixed two of the deficiencies originally identified by the government agency charged with oversight of care in California, it still didn’t fix two others to the agency’s satisfaction.
The two issues still a problem for Kaiser are: providing timely appointments for behavioral and mental health services, and Kaiser’s inability to share information with patients.
What’s the point of offering mental health care if nobody can access it?
Here’s what California Healthline had to say:
According to the report, 22% of medical records reviewed among Kaiser’s Northern California facilities failed to meet state guidelines for timely access to care, compared with 9% in Southern California.[…]
The report also found that Kaiser staff had misled patients about what benefits were covered and, in some cases, recommended patients seek care from somewhere else.
The problem of providing timely appointments is a simple one to fix — hire more clinicians. Problems in hiring clinicians? Offer more money. Don’t want to offer more money — or hire more clinicians — because it’ll cut into your multi-billion dollar profit margin?
Well, sorry, nobody’s going to feel sorry for you.
When one in five of your patients can’t access services in a timely manner, that’s a problem. According to Kaiser’s internal reporting of access wait times, by the end of 2014, the problems had been fixed. But according to the independent review of 297 random patient records (taken from earlier time periods), 22 percent of patients still didn’t get a timely appointment.
Obviously there are still problems in the Northern Region of California, which has the biggest volatility in its access rates. It’s not clear what was causing the volatility, but once they started hiring external providers via ValueOptions, access rates skyrocketed and maintained for the latter part of 2014.
This suggests that Kaiser could have fixed the access problems much earlier on, had it simply contracted with ValueOptions sooner. Why didn’t it? It’s not clear, and Kaiser isn’t saying. It could have had something to do with the cost of outsourcing to external clinicians, or the belief that Kaiser would be more successful in hiring its own clinicians.
The trend is encouraging however. It appears that — after years of complaints about its inadequate mental health services in California — Kaiser is finally fixing them. The real question is whether Kaiser will maintain these gains when they are no longer under the regulators’ scrutiny.
Read the full report: Routine Survey Follow-Up Report of Kaiser Foundation Health Plan (PDF)
Read the news article: DMHC: Mental Health Services Deficiencies Remain at Kaiser