For the past 17½ years, I’ve practiced as a community mental health psychiatrist in Maine. I work for a nonprofit community mental health center providing care for patients with all types of insurance, predominantly MaineCare.

Maine has very few psychiatrists and advanced practice psychiatric nurses to serve our large and primarily rural state. Many of these psychiatric providers choose private practice and typically do not serve patients with MaineCare.

Gov. LePage has proposed cuts to the MaineCare reimbursement rate for psychiatric medication management services, for the 2016-17 budget.

The cuts will reduce current reimbursement to community mental health centers for psychiatrists by 60 percent (and more for psychiatric nurses). Such devastating cuts will very likely have the following tragic effects:

• Expansion of psychiatric services into the many currently underserved parts of Maine will grind to a halt.

• Many outpatient psychiatric medication management practices will close, leaving thousands of current patients without psychiatric treatment. The job losses will negatively impact Maine’s economy.

• Patients will destabilize, resulting in an overutilization of expensive emergency rooms and inpatient psychiatric hospital beds.

• Patients in psychiatric hospital beds will stay longer as it will take longer to arrange a discharge with a rapid appointment with an outpatient psychiatric provider.

A weeklong stay in a psychiatric hospital costs MaineCare much more than a full year of outpatient psychiatric medication management treatment, so all presumed savings from the cuts will be a wash.

• Primary care doctors will be forced to provide treatment to more patients with severe psychiatric illness, but given their lack of expertise, they’ll end up prescribing more medication, resulting in greater costs to MaineCare for failed medication trials.

Marc I. Kaplan, D.O.

Kennebunk

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