Alma, Aetna, and VC-backed platforms
Alma recently announced Aetna is cutting reimbursement rates by up to 40%.
According to the announcement, extended sessions (90837) will no longer be reimbursed at a higher rate.
Aetna is also moving to a single rate across all provider credentials, meaning therapy sessions billed by doctoral-level psychologists will be reimbursed at the same rate as masters-level providers.
Note this only applies to Alma providers credentialed with Aetna. But it does have broader implications.
Therapists have worried about VC-backed platforms like Alma cutting reimbursement rates once they hit a critical mass. Psychotherapy Action Network did some great research on concerns with “practice management companies” here.
In their announcement, Alma said they “disagree with these changes” and would advocate for higher rates but they were recently acquired by Spring Health, so who knows if this was all part of the plan.
Regardless, if it can happen to Alma providers credentialed with Aetna, it could happen to you if you’re contracting with a VC-backed platform.
Is it less risky to do your own credentialing and billing? Sure, but it’s also more time consuming. So it’s all about trade offs.
Personally, I think companies like Alma are great for therapists who are newer to private practice and want to take insurance without the headache. Long term, if you plan to take insurance, then it probably makes sense to own your own contracts.