The internship consists of close collaboration on a team that is working to develop a “mental health (MH) insurance plan scorecard”. This scorecard will use available data to rate CT insurance plans (and neighboring states) on metrics, such as: (1) MH services covered (2) MH reimbursement rates (3) MH network adequacy (4) MH denial rates (5) MH price (reimbursement) parity with behavioral health (BH) (6) MH network parity with BH and (7) transparency around MH outcome data.
The scorecard will aim to create accountability and competition among medical insurance plans with respect to the mental health benefits they o_er and help stakeholders to enforce of the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. Currently, the MH benefits that such plans o_er are obscured via diversity of reimbursement mechanisms, “ghost networks” (purported lists of in-network providers who either are not accepting patients or are not in-network at all), and discriminatory practices that prevent coverage for adequate mental health treatment. These obstacles have prevented employers, politicians and other key stakeholders from enacting the needed changes around mental health coverage and accountability of MHPAEA. These dynamics have contributed to the mental crisis facing our country, seen as two out of five adults report symptoms of mental illness and approximately 37% of the U.S. population are living in areas of mental health professional shortages.
The intern will join an existing team of three professionals with extensive experience in this area: Andrew J. Gerber, MD, PhD, President and Medical Director, Joel Bernanke, MD, Strategic Advisory on Psychiatric Research and Service Development, and Meredith Pyne, LMSW, MBA Research Associate. The team will support the development of the MH scorecard, bringing increased transparency to an opaque and complex industry.
The intern will be expected to work 40 hours per week with a flexible work schedule that allows at least 3 hours of individual weekly meetings with Drs. Gerber, Bernanke and Meredith Pyne, as well as group meetings as needed, attendance of weekly Grand Rounds (1.5 hours) and other educational events as appropriate, and meetings with outside advisors including experts in the field of mental health parity and major employers (including Silver Hill board members and advisors) who can help consider how best to analyze and present the data on the scorecard. The rest of the intern’s time will be devoted to doing independent research, data analysis, and writing to design the scorecard with the guidance and feedback of the research group, led by Dr. Gerber. The location of the internship is flexible and much of this work can be done remotely, though we recommend at least 20 hours over the course of the summer program would be spent onsite at Silver Hill to get to know the sta_ and work of the hospital, in support of the mission of this project. If the intern is able and interested, they can shadow health care providers at the hospital (psychiatrists, psychologists, social workers, or nurses) to observe and get a good understanding of the work of a psychiatric hospital. If the intern is interested and able to spend more time at the hospital, an o_ice would be provided up to 40 hours per week.
Dr. Gerber leads this project and will work closely with the intern, through at least 1 onehour individual meeting per week (in person or virtually) as well as regular (ideally, daily) email contact with the intern as the project develops. Dr. Gerber is highly personally invested in this project, having served as an expert witness in several class-action lawsuits against major insurance companies for violating federal parity laws and failing to provide adequate reimbursement for medically necessary psychiatric treatment.
The goal of this project is to have a full template for the scorecard by the end of the internship and a corresponding white paper, authored by the summer intern, on how the scorecard was constructed and how it will be used to create a competitive market among health plans and increase the pressure on both employers and insurance companies to provide better and more transparent coverage of treatment for mental illness and addiction. The scorecard and white paper will then be used to convince employers to pressure insurance companies to develop better health care plans and to raise money to extend the use of this scorecard and keep it updated. If the intern is interested in doing so, this white paper could also be turned into a journal article submission for publication in a health care policy or mental health services journal. The intern will have the opportunity to be first author on such a publication.