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NEDA TOOLKIT for Parents How to find a suitable treatment setting Several considerations enter into finding a suitable treatment setting for the patient. The patient’s options may be limited by his/her available insurance coverage, by whether or not a particular center or therapist accepts insurance, and the ability of the patient to pay in the absence of insurance. Primary care physicians (i.e., family doctor, gynecologist, pediatrician, internal medicine doctor) may be able to play a valuable advisory role in referring patients for treatment if they have had previous experience with referring to eating disorder facilities, participating as a member of a care team for a patient with an eating disorder, or outpatient therapists. Some primary care physicians, however, don’t have much or any experience in this area. Therefore, it’s important to ask about their experience before asking for a referral. In 2005 and again in 2007, ECRI Institute (a nonprofit health services research organization) sought to identify all healthcare facilities that stated that they offered treatment for eating disorders. This included hospitals, psychiatric hospitals, residential centers, and outpatient-care facilities. We surveyed treatment facilities nationwide to obtain information about their treatment philosophies, treatment approach, years of experience, and the clinical and support services they offer. The information is available in a searchable database, www.bulimiaguide.org. This database focuses on facilities offering any or all levels of care (see the tool explaining Treatment setting and levels of care). It does not include a listing of individual therapist outpatient practices. For information on outpatient-only therapists, go to the “treatment referral” source at www.nationaleatingdisorders.org; www.something-fishy.org/treatmentfinder; or www.edreferral.com. Determining Quality of Care Determining the quality of care offered by a center is difficult at this time. No organization yet exists to specifically accredit treatment centers for the quality and standard of eating disorder-specific care. Leaders within the national eating disorders community organized in mid-2006 to develop care standards and a process for accrediting eating disorder centers. That effort is ongoing. One national organization, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), provides generic accreditation for healthcare facilities, and some eating disorder centers advertise “JCAHO accreditation.” JCAHO accreditation does not link directly to quality of care for treatment of eating disorders. Another issue regarding quality of care is that much care is delivered on an outpatient basis. For individual psychotherapists in private practice, no special credentialing or specialty certification exists regarding treatment of eating disorders. Thus, any mental healthcare professional can offer to treat an eating disorder whether or not he/ she has experience or training in this specific area. Therefore, it is important to ask a prospective therapist about his/her knowledge about eating disorders and years of experience treating them. Factors Affecting Choice of Treatment Center For insured patients, the choice of a treatment center may be dictated by the beneficiary’s health insurance plan. Health insurers should provide a list of in- network (covered) treatment centers. If the treatment center is outside of the health insurer’s system (out-of- network), the insurer might pay a percentage of the treatment costs leaving the patient responsible for the remainder. It is best to negotiate this percentage with the insurer before starting treatment. A small number of treatment centers offer financial assistance; but most do not. However, inquiring about treatment scholarships, as they are termed, may be worth investigating if the patient does not have financial resources or insurance. Page | 56