"The Business" of Behavioral Healthcare | Behavioral Health Today

The Blue Cross and Blue Shield Association Unveils Action Plan To Improve Healthcare Quality And Rein In Rising Healthcare Costs

Comprehensive new proposal will save federal government more than $300 billion

October 4, 2011

Contact: Kelly Miller (Media Inquiries Only) 202.626.4825

WASHINGTON – The Blue Cross and Blue Shield Association (BCBSA) today released a comprehensive, interconnected action plan that fundamentally transforms the healthcare system, moving it away from a fee-for-service model to a patient-centered model. [...]

New Health Care Cost Institute to Transform the Study of U.S. Health Care Spending

First-ever Collection of Data from Leading Private Sector Insurers will Enable Broadest View of Health Care Cost Drivers and Trends

(September 20, 2011) – The Health Care Cost Institute, an unprecedented health research initiative launched today, will allow researchers and policymakers access to a comprehensive collection of health plan and government payer [...]

CMS Announces Comprehensive Primary Care Initiative

The Comprehensive Primary Care (CPC) initiative is a new CMS-led, multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care for all Americans. Primary care is critical to promoting health, improving care, and reducing overall system costs, but it has been historically under-funded and under-valued in the United [...]

New Illinois Parity Law Recognizes State Funded Addiction Treatment Providers

Community-based addiction treatment providers named specifically in law as covered providers

(Springfield, ILLINOIS) – In a move that raises the bar for addiction treatment advocates and legislators in other states, state-funded addiction treatment providers were specifically codified in to law as covered providers when Illinois Governor Pat Quinn signed the Illinois Mental Health [...]

ASAM Redefines Addiction as a Chronic Brain Disorder – More Medicalization on the Horizon?

MSNBC carried the following story today (August 15, 2011): Addiction is a chronic brain disorder and not simply a behavior problem involving alcohol, drugs, gambling or sex, experts contend in a new definition of addiction, one that is not solely related to problematic substance abuse.

The American Society of Addiction Medicine (ASAM) just released [...]

Magellan Launches Integrated Health Homes in Iowa

The following press release is a very good indication of where the market is and where it is headed. The time for innovation and bold moves to reform health care and delivery systems is now. The time for new business models and entrepreneurship and leadership is now. As much as some states and [...]

Health Insurance Exchange Proposed Rules Released for Comment

Federal regulators released proposed rules concerning the implementation and governance of Health Insurance Exchanges – the new marketplaces established by the Affordable Care Act where individuals and small businesses can purchase health insurance. Behavioral health policymakers, payers and providers are encouraged to review the rule and comment within the 75-day window of opportunity. The [...]

Carve-out versus Carve-in: Considering the Advantages and Disadvantages

As you review the fundamental pros and cons of either approach, consider asking an expert for direction and guidance before making any decisions you might come to regret. It is this author’s humble opinion that while a carve-in may appear attractive for reasons having to do with short-term costs, in the long run, mishandling [...]

For-Profit Publicly Traded Medicaid Managed Care Plans Rack Up Higher Admin Costs

The Commonwealth Fund reports that for-profit publicly traded plans spent 14% of member premiums on administrative costs, while non-publicly traded plans owned by health systems, local providers and clinics spent 10% of premiums on administrative costs. Provider-owned and operated plans had the lowest administrative costs, with a paltry 8% of member premiums spent on [...]

Carve-In Making a Comeback?

One of the ten largest health plans in the country announced recently that it will be in-sourcing what it had previously out-sourced: Disease Management. A quick review of their rationale exposes some very compelling reasons to carve services back into the broader health plan suite of functions.

For starters, the health plan expects to [...]

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