HHS has issued its proposed regulation on accountable care organizations (PDF), the new delivery and payment model the agency expects will serve millions of Medicare beneficiaries through participating providers. Medicaid, health plans, insurers and self-insured employer health plans are rapidly moving in the same direction. Launching this new era and version of managed care is [...]
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The Federal Health IT Strategic Plan (2011-2015) and the National Strategy for Quality Improvement in Health Care were both released last week and each will have a profound impact on the treatment of mental health and substance use disorders in the coming years. Each has implications for the field and each is fairly straightforward. [...] Others have written brilliant pieces on the anniversary of reform so I won’t try to duplicate any of their work. Rather, I’d like to look in places many behavioral health folks don’t look. Health Insurers and Managed Care Organizations– According to Market Watch today, shares of the six major insurance companies in the S&P [...]  March 23rd, 2011 |  Leave a comment |  "The Business" of Behavioral Healthcare, Regulations & Legislation More than two-thirds of states cut mental health funding from their general fund budgets over the last two years, according to a report released by NAMI last week. New York’s Governor Cuomo submitted a budget that strips education in that state of more than $1B in funding in the coming fiscal year. California’s Department of Mental [...] I’m attending the ACMHA (“The College”) summit in New Orleans this week and several discussions under the banner of “Disruptive Innovation” enlighten me, frighten me, and concern me. Most of all, when leaders from this field assemble in March 2011 to proclaim we are riding a wave of innovation, it makes me nervous. The fact [...] Between the President’s budget for 2012 (making remarkably little progress from one week to the next), hammered state budgets, and the lingering sense that we’re still in a recession (which we aren’t), the behavioral health field continues to feel as though it’s been asked to sit at the kids table again [...] Bending the Cost Curve is one of those health care reform catch-phrases that sounds so alluring and cutting-edge. Everybody feels a little smarter saying it out loud in public places. Some people feel so good about it, they say it over and over again until - sadly – it begins to lose it’s original lustre [...] We recently received the following question from a behavioral health care provider: “Correct me if I’m wrong, it is now illegal for group health insurance plans to limit the number of visits for mental health/substance abuse treatment (out-of-network or in-network) if they first, offer mental health/substance abuse benefits and second, do not limit the number [...] Kaiser of Northern California is taking the role and importance of behavior modification very seriously. They recently added a new service that allows their members to call a Masters level behavioral health clinician for lifestyle coaching with respect to their weight loss, diabetes treatment compliance, pain management and other conditions that fall under the new umbrella [...] Behavioral health care providers of all stripes are encouraged to revisit their services, reimbursement, and revenue management but before they do they’ll need to flex and train what for many of them will be new muscles: product development and marketing. The reason? Implementation of the Affordable Care Act (reform) is already fomenting a rash of mergers and [...] |
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