Curious_Buffalo_1206 t1_j7kl3jq wrote on February 7, 2023 at 2:00 PM

Reply to comment by Full_Whereas_2694 in Lawmakers consider interstate compact for mental health counselors by greenhousecrtv

Insurance reimbursement rates don’t vary that much by state. It’s why the SF Bay Area has absolutely abysmal access to mental healthcare, despite being so phenomenally wealthy. Who in their right mind would work there, when you’d make 90% of your salary in Sacramento and be able to afford a house?

I don’t see how this wouldn’t be a boon for VT. MA is right there across the imaginary line in the sand, minting new mental healthcare professionals with gargantuan debts who’d be eager to find a lower cost of living.

I’m not convinced that many will move to VHCOL areas in search of patients paying out of pocket. The 1% don’t have issues with shortages. The demand for that market is already satisfied.

Full_Whereas_2694 t1_j7l39nw wrote on February 7, 2023 at 4:10 PM

Interesting points for sure. Mass isn't anywhere near signing onto the compact, so for now it's a bit of a moot point. I think the bigger question is telehealth-practitioners won't actually have to move to serve clients in other states. Or it's possible that professionals in urban areas will move here for a better quality of life but continue serving their clients who live elsewhere. It's a huge unknown. I'd love to see some better data. Here's the link to the states who are in process or have already signed onto the compact: https://counselingcompact.org/map/ I think counseling is unique from a telehealth standpoint and this type of massive interstate market doesn't really exist for other types of healthcare yet, so there may be unintended consequences. I'm not saying it's a negative, just an unknown.

Curious_Buffalo_1206 t1_j7l5a0n wrote on February 7, 2023 at 4:23 PM

It’d be interesting if this meant psychiatrists were allowed to send prescriptions for certain controlled substances with critical shortages over state lines. It probably won’t happen, because the DEA created those shortages intentionally, but it would sure be nice.

Now that probably raises alarm bells to some, but that would be part of integrating mental healthcare across state lines. Several controlled substances are critical in psychiatry.

That telehealth aspect makes me a lot less supportive of this whole thing, TBH. Empirically speaking, telehealth for mental healthcare has been kind of a disaster. BetterHelp is a gross scam. Done and Cerebral were running a nationwide pill mill during the rona. Telehealth should be more regulated, not less. You should have to see the provider in person occasionally IMO.

I thought this was about transferring licenses, not practicing in 19 states simultaneously. The only people that sounds good to, are Silicon Valley grifters trying to commoditize mental healthcare.