Call to Action: What Substance Use Disorder Treatment Providers Can Expect in the New Business Paradigm

I am asked repeatedly to answer this question of bottom-line impact for the field of substance use disorder (SUD) treatment providers. I suspect it has something to do with their long-time marginalization and the endemic fragmentation of our whole health care system. Frankly, nowhere is fragmentation and neglect of the fundamentals worse than where SUD [...]

Behavioral Health Recommendations for Accountable Care Organizations

As we begin to chart our course toward Accountable Care Organizations, let us keep in mind that mental health and substance use disorder providers are often starting their journey from a different point of origin than are their medical counterparts. Let’s face it, behavioral health providers are often under-resourced and under-capitalized compared to MSOs, IPAs and [...]

Budgets Cut to the Bone, Forcing Behavioral Health into Emergency Rooms

We’ve heard much about the 32 states that have cut a combined $1.8 billion in non-Medicaid behavioral health funding in the past 2 years and yesterday we learned about an additional $46 million coming out of the SAMHSA budget as a result of the recent agreement on the Federal budget. The National Association of State Mental [...]

The Infamous Health Care Cost Curve: Applying the 80/20 Rule

Americans are spending more than $2 Trillion per year on health care. That number by itself is not so meaningful. What is meaningful is the fact that it represents nearly 1 in every 5 dollars in our entire economy.  Notwithstanding the fact that someone is consuming health care while someone else is providing it while a [...]

Costs of EHR Implementation Coming Into Clear View

A recent study, “The financial and nonfinancial costs of implementing electronic health records in primary care practices,”was conducted by researchers from Baylor Health Care System, Emory University, and the HealthTexas Provider Network (published in the March 2011 issue of Health Affairs).The study puts the cost for an average five-physician primary care practice at$162,000 for implementation and an additional$85,500 [...]

Budget Proposal Would Adversely Impact Medicare and Medicaid Beneficiaries’ Behavioral Health

Rep. Paul Ryan, R-Wis., recently touted the House Budget Committee chairman’s alternative budget and how it would turn Medicare over to private insurers for anyone who retired after 2021. Retirees would receive a “capped payment” or “premium support” to buy insurance whereas Medicaid would be converted into a capped Block Grant to states.

What the [...]

ACOs Require State-of-the-Art Health IT Infrastructure

Providers that want to form Accountable Care Organizations (ACOs) must get serious about health information technology. CMS, in 429 pages of proposed regulations, establishes the imperative of IT in their plans as well as the intrinsic relationship between ACO IT infrastructure and the Meaningful Use incentives payable under the HITECH Act.

CMS views value-based purchasing [...]

ACO Resources for Behavioral Health Providers

Long-awaited proposed ACO regulations were issued yesterday and the buzz online is overwhelming. This hearkens back to Gold Rush days and anytime there is that much buzz, we can either expect a bubble to form or we can predict that some people are going to get hoodwinked by some other folks. The trick for behavioral [...]