Tag Archives: fee for service

Shifting Away from Fee for Service Towards Coordinated Care Payment Models

I know I sound like a broken record on this one, but the substance abuse treatment industry is now in the same boat as the rest of the healthcare payment model when it comes to reimbursements. That¹s good news for many (more people covered with insurance + parity in services).

However, that also means that treatment providers need to start planning ahead for the eventual migration away from the fee-for-service model and towards a coordinated care model.

While this article suggests that it is the states which need to figure it out, I still believe that the private sector is in the best position to determine cost efficiencies and then work with state legislators on crafting workable solutions.

But there is no doubting (in the absence of amendments or repeal of the Affordable Care Act) that treatment providers who rely upon private pay insurance must begin to analyze their business models for future sustainability.

Read the Modern Health article here:
http://www.modernhealthcare.com/article/20140108/NEWS/301089971

Providers brace for fee-for-service conversion

Staffing, reporting, clinical, and claims management challenges await as grants give way to third-party payers.

Historically, grant funding played an important role in building and sustaining the service capacity of community mental health and addiction treatment services, particularly for underserved or marginalized populations. But, amid the backdrop of historic shortfalls in federal and state budgets and years of successful advocacy for behavioral health parity, insurance reform, and expanded availability of accountable and high quality healthcare for all, the scope and availability of grant funding is rapidly changing.

Read the article at:
http://www.behavioral.net/article/providers-brace-fee-service-conversion