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After years of state sanctions and fines, Kaiser Permanente claims it has gone a long way toward improving its mental health care.

The national managed-care giant — California’s largest insurer with 9 million members — touts more than 1,200 therapist hires since 2016, improved patient access to appointments and an expanded training program for mental health professionals. Regulators at California’s Department of Managed Health Care report that Kaiser is meeting the benchmarks laid out in a 2017 settlement agreement that resulted from two years of negotiations.

But interviews with dozens of Kaiser Permanente therapists, patients and industry experts paint a more troubling picture of superficial gains that look good on paper but do not translate into more effective and accessible care. Many Kaiser patients still struggle to access ongoing treatment, often waiting two months between therapy sessions.

Kaiser therapists say that the HMO has figured out how to game the system set up by California regulators to measure progress without meaningfully improving care. They describe a model that relies on perfunctory intake interviews, conducted by phone from call centers, to show improved response times for patients seeking an initial appointment but then fails to follow through with timely or regular follow-up care.

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