Statement Regarding Anthem’s 35% Rate Reduction for Applied Behavior Analysts and Other Providers

Recently, Anthem communicated to their provider network that several providers, including ABA providers, will be receiving rate reductions. Used as a scientific approach to understanding different behavior, applied behavior analysis (ABA) is a method of therapy used to improve or change specific behaviors.

ABA providers will face a 35% rate reduction. This follows a 2011 rate reduction of 15-30% for ABA providers, with no rate increases during the years in between. Several providers report that Anthem has stated this reduction is non-negotiable.

The Arc of Indiana is concerned that this significant rate reduction will negatively impact ABA providers and individuals who can greatly benefit from ABA therapy. We are also concerned that these significant rate reductions will negatively impact other providers and recipients of those services.  We believe that all providers should receive reimbursement that allows them to hire and retain a quality workforce and cover the true costs of providing quality services, including staff training and continuing education.

We believe that this rate cut will force providers to leave the Anthem network, and possibly leave the state, in order to stay in practice. Even if a family does not have Anthem, the rate cuts could affect care if providers are forced to cut jobs or “cut corners” in providing care. The state-wide shortage of ABA providers, coupled with the fact that there is no state oversight of ABA provider companies, makes this a very concerning situation as families deserve the highest quality of services.

While Anthem employs over 2600 Hoosiers, several thousands of Hoosiers are employed as health care practitioners that directly see patients and provide care and treatment to improve their health and well-being.  These cuts could have a significant impact on these jobs and the families that depend on the services they receive.

The Arc questions why Anthem chose to cut provider reimbursement over other possible cost reduction measures that would not have a negative impact on quality of care or access to behavioral health services for some of our most vulnerable Hoosiers.

Families have asked us, what can we do?

  • Contact your employer HR or benefits department and express concern that provider rate cuts from Anthem may hurt quality of care for all.
  • Contact your state legislator and copy Governor Eric Holcomb and Lt. Governor Suzanne Crouch on your correspondence.
    Find Your Elected Officials 
  • Contact the Indiana Department of Insurance
    https://www.in.gov/idoi/2961.htm

We hope Anthem will engage providers, employers and subscribers as partners to approach the issue of healthcare costs in a manner that enhances quality of care while addressing value and improving health outcomes for our state.