The Emily Program, an eating disorder treatment center with locations in Minnesota, Washington, Ohio, and Pennslyvania, has adopted a new clinical model that will focus more on acute intensive care, and less on long-term outpatient care.
The new model was announced on Wednesday. As a result, some outpatient clients have already been told their treatment will be discontinued on January 2, 2018. More will be notified in one-on-one conversations in the days and weeks ahead.
Patients being dropped say they feel like they're being forcibly graduated from the program before they've recovered.
One St. Paul woman, who asked not to be named, was told last week her services would be terminated in the new year. She has been a patient with the Emily Program on and off for 15 years, but had recently relapsed.
She says she called the Melrose Center but couldn't get an intake appointment for a month because eating disorder specialists are already swamped. If there is a mass exodus from the Emily Program, she fears many patients will not be able to find a new provider.
"These are very vulnerable people, and they're all going to be left without therapists and psychiatrists, to fill their meds. A lot of people are going to relapse. People could die."
Heidi, of Medina, had just finished an intensive outpatient program when she was told that her therapist's position had been eliminated, and she would be offered just one additional year of outpatient treatment.
"Something I've been told is that recovery happens in outpatient while I'm also living and building a life," she says. "[The Emily Program is] very clearly disagreeing with their own statement by prioritizing higher levels of care and kicking out many outpatient clients."
Patients worry the changes had been driven by business concerns, guided by the Emily Program's new financial partner, Triple Tree heathcare investment bank. Weeding out long-term, outpatient clients could superficially improve recovery statistics. And focusing on acute, intensive care treatment, which insurance companies reimburse at higher rates, would be more lucrative for the program.
"That's what's concerning, that it seems like they're turning into this for-profit, money-making machine when they should be focusing on what the client needs," says former patient Deborah Taillon, also of St. Paul.
Many patients in Washington state have also been affected.
The Emily Program's chief strategy officer, Jillian Lampert, says the new clinical model aims to make the best use of limited resources in order to treat the people most in need of intensive care and save lives. It is also designed around "measuring" the impact of that care, to have better statistics to show clients, investors, and insurance companies that the program's methods work, she says.
"What's driving us is not in any way the billing of one service over another," Lampert says. "There are so many people who aren't getting care, who need this specialty care, that we are focused on serving a population that is not getting the access to care to start with."
As a result, some outpatient clients will be set adrift. Lampert declined to guess how many, saying those conversations will take place in the next few weeks.
Those discharged will be patients assessed to be well enough to transfer to a general mental health provider, she says. Some clients have progressed to the point that their eating disorder is no longer their primary problem, and other issues like anxiety and depression have risen to the top of their diagnoses.
Patients who have already been told this line of reasoning disagree. They say weekly meetings with therapists and dieticians they've come to trust over many years are what keep them from relapsing into using food in destructive ways. And while symptoms frequently come wrapped in ancillary mental health issues, only a specialist could address their eating disorders.
Becky Morrow of Woodbury was recently told her therapist's position would be eliminated at the end of the year to accommodate the new model. When she began with the Emily Program in 2012, stress from an abusive relationship overshadowed treatment for her eating disorder. But then her therapist helped her leave the relationship, and for the past year they've finally begun to make progress on her eating disorder.
"I know among a lot of the clients who have been talking about it, there's so much emotion around all of this that it's causing a lot of increase in anxiety and wanting to restrict food or purge food or binge eat, or whatever coping mechanism we're using," Morrow says.
"It's really hard when it's this clinic that says it's dedicated to treating you, whole body, in recovering from your eating disorder, it just feels like they're kind of changing how they define an eating disorder to an extent. We're not good enough or we're not bad enough to continue to stay there."