Obamacare is hurting the middle class as prices for purchasing a health plan is either not affordable and/or is affordable but has a high deductible and coinsurance strings attached. In my neck of the woods, as an example, I am finding that the average price for a decent plan with a $ 1500.00 deductible is over $ 1200.00 a month for a family. Some of these plans do cover for outpatient mental health with a co-pay but other plans require individuals to pay out of pocket costs until their deductibles are met.
What does this mean for my private practice? Honestly, I am getting referrals for counseling but some of my clients can only come once a month due to having to pay out of pocket before their deductibles are met. As a result, it is not clinically practical for these clients to receive effective treatment for their symptoms. Ironically, the State of Massachusetts added 30,000 more people to the Medicaid/subsidized plans with more people being added as I write this post. What does this mean for my private practice? I can take a few clients who have Medicaid under managed care plans. However, most of these clients live in the city where there other clinical services are easily accessible to them. Also, due to the loop holes to get subsidized or free health care, some people are choosing to work less hours and/or not get married to raise their families.
In my other part-time job, I am receiving more referrals for clients who have Medicaid insurance. However, I only get paid a small cut as the agency gets the rest for their administrative costs.
What can clinicians do who are facing these issues in their private practice? Here is a list of what I am doing to get more referrals and to augment my business:
1) I contacted several Employee Assistance Programs (EAPs) to inform them that I am currently taking on new referrals. I am finding that some clients are using their EAP benefits to come to counseling as it is free for them to attend.
2) I work with other practitioners who specialize in alternative care and healthy eating. We met and worked on promoting each other’s business with an elevator pitch method when we meet with our clients. The owner of the suite will be posting a big sign to market our services to the members of the health club (my practice is located in a gym) as well as to other clients who come in for our services.
3) I am training to be a teacher for English Language Learners. Since I enjoy teaching adults, I look forward to teaching classes for beginners and for intermediate students this year. This opportunity will augment my business as I like to do different things for a living.
4) I will continue to network with other providers by attending conferences and promoting my business through linked in. I am finding though that several companies and agencies have cut back on inviting presenters to come in to train their staff.
Though I am disappointed that Obamacare will hurt the middle class in affording outpatient counseling services, it does provide another opportunity to be creative in augmenting your private practice.
Robbin Miller is a counselor who specializes in mindfulness meditation; Positive Psychology; and Cognitive-Behavioral Therapies; and is also a volunteer cable access producer and co-host of her show, "Miller Chat" in Massachusetts.