ALAMEDA, Calif., Oct. 27 /PRNewswire/ -- Telecare Corporation announced today that it plans to withdraw as a Specialty Provider Network (SPN) from the NorthSTAR behavioral health network that serves Dallas and six surrounding Texas counties. Under an agreement with ValueOptions, the national behavioral managed care company that manages NorthSTAR, Telecare will continue to provide mobile crisis services. During the next 60 days Telecare will transition its current 1,200 consumers to another SPN, subject to approval by ValueOptions.
“Reimbursement for much of the array of mental health services we provide has been dramatically reduced in the past two years and it is no longer a financially viable operation,” said Ross C. Peterson, vice president for Telecare. “While this has been a very difficult decision, we really have no other choice. We’ve exhausted all of our options.”
As an SPN, Telecare provided a wide range of outpatient and Assertive Community Treatment (ACT) services to NorthSTAR, a mental health “carve out” program in which services are organized and managed by companies specializing in mental health, independent of the primary health care delivery system.
Over the past four years Telecare has taken a variety of steps -- including reorganizing services and proposing alternative, cost-effective approaches to care -- to adapt to declining reimbursement levels and changes in how rehabilitation benefits are being defined, “Telecare is an extremely efficient and cost-effective organization. In spite of the best efforts of our very dedicated and committed staff, changes in the state and ValueOptions formula for reimbursing services for NorthSTAR consumers -- coupled with significant rate reductions - have made it impossible to financially break- even,” said Peterson.
The NorthSTAR mental health care system blends local, state and federal funding to serve eligible persons with severe mental illness in Dallas and six surrounding counties. A collaborative effort between the Texas Department of Mental Health and Mental Retardation, and the Texas Commission on Alcohol and Drug Abuse, NorthSTAR is a network of mental health providers whose services are coordinated by ValueOptions, a national managed behavioral health company (http://www.valueoptions.com/).
ValueOptions, under contract to the state, contracts with providers who serve approximately 30,000 Medicaid and non-Medicaid eligible consumers each year, and of that group, Telecare has served over 5000 persons annually.
“Our first priority is the care and safety of our consumers,” said Marti Wagner, regional director of operations for Telecare’s NorthSTAR network. “We will work closely with ValueOptions and state agencies to assure that each consumer is transitioned to another provider with no lapse in care.”
According to Telecare, all consumers will be contacted within the next few days and individual meetings scheduled to arrange for a smooth transition to another care provider.
According to Peterson, NorthSTAR is not adequately funded for the broad range of services and populations it currently serves. With changes effective in September, 2004, the rate for individual rehabilitative services in the rest of the state is more than 50% higher than the rate for the same service in NorthSTAR. In the past year, reimbursement rates have been reduced as follows:
* In November 2003, State Medicaid office redefined a “unit of rehabilitation service” resulting in a significant reduction in reimbursement rates; * In February 2004, ValueOptions implemented a 10% rate reduction for rehabilitative services; * In September 2004, ValueOptions eliminated billing for service coordination, resulting in a 9 percent reduction in total Telecare NorthSTAR SPN revenues
At any given time, Telecare SPN serves approximately 1,200 consumers through a network of licensed social workers, psychiatrists, nurse practitioners, registered and vocational nurses, and care managers. Services include assessment and risk review, assertive community treatment (ACT), community support services, and a medication clinic.
According to Peterson, one option for remaining in the network was to focus Telecare’s services only on its Assertive Community Treatment (ACT) program: “Unfortunately, ValueOptions did not view this as an alternative under the current SPN configuration.”
Telecare will continue to provide mobile crisis services to NorthSTAR consumers (Collin, Dallas, Ellis, Hunt, Kaufman, Navarro and Rockwall counties) in need of urgent psychiatric care.
“Mobile Crisis teams see consumers in their homes and other community environments and strive to provide services in the least-restrictive environment,” said Wagner. “When it is clinically necessary, the Mobile Crisis teams will also refer consumers to more appropriate treatment options or link them with appropriate providers.”
Telecare is one of the largest providers of adult mental health services in the country. Based in Alameda, Calif., Telecare works in partnership with local, county, state and other behavioral health organizations to design and provide a wide range of innovative, recovery-focused, outcomes-driven services and supports for high-risk individuals with complex needs. Telecare is an employee and family-owned organization with over 1,900 employees and more than 50 programs in California, Texas, Oregon, and North Carolina.
Telecare Corporation
CONTACT: Shea Tokar of Telecare Corporation, +1-510-337-7952, ext. 159