Boston Children’s Hospital Leaves Harvard Pilgrim Mental Health Network

Boston-based Children's Hospital has dropped out of Harvard Pilgrim Health Care Inc.'s network of mental health providers, rejecting a contract offer that it said would have caused it to lose $570,000 a year, the Boston Herald reports. The move means that as of July 1, Harvard Pilgrim beneficiaries no longer will be able to use Children's mental health services unless they pay out-of-pocket or are referred by Value Options, the for-profit company that manages mental health services for Harvard Pilgrim. Children's and Harvard Pilgrim have been moving patients to other providers since contract negotiations between the two broke down in April. William Beardslee, chief of Children's psychiatric services, said that Harvard Pilgrim had asked the hospital "to provide the same care for less money than last year ... and the cost of taking care of children has gone up significantly" (Powell, Boston Herald, 6/21). Beardslee said, "We do a higher percentage of free care than any other department in the hospital. We try to take the most difficult cases. We have to be adequately reimbursed from those people who have health insurance" (Dembner, Boston Globe, 6/21). But Value Options Executive Vice President Richard Sheola said that Children's charges three to four times as much as what other providers do. He added, "I can't negotiate a special rate with Children's -- then everyone would want that" (Boston Herald, 6/21).

Statewide Shortage
The move means that up to 60 doctors and therapists and 18 hospital beds will be eliminated from Harvard Pilgrim's mental health network. Dr. Frederick Stoddard, past president of the Massachusetts Psychiatric Society, said, "This is significant not only because Children's Hospital is a world-renowned provider of services for children but because this is but one instance of a problem that is felt across the state" (Boston Globe, 6/21). Psychologist Paul Ling said that the state is experiencing a shortage in mental health services for children. Psychologist Alan Gruber, who opted not to sign with Harvard Pilgrim, added, "The issue here is that a profit-making company like Value Options by virtue of being a business is more concerned about costs than services. And Harvard Pilgrim regrettably chose to discriminate against people with mental and emotional problems as a way of cost-containment" (Boston Herald, 6/21).