Tag Archives: treatment centers

Further Discussions on the Marketplace Impact of the Affordable Care Act

As initially predicted, the marketplace is moving towards consolidation of services and this may likely begin to see capture in the substance abuse treatment services in the coming 12-36 months. Possibly later.

The trends leading to this uptick in deals over the past year or so increasing health care costs, growing demand for services, consolidation of doctor groups were in place before the law. But experts say the ACA magnified their importance and expedited hospitals’ response.In one sense it just means there’s a higher need for medical office buildings. At the same time, hospitals are trying as they acquire physician groups to gain market share and use the physicians as a gateway into the market, said Ross Yustein, chair of Kleinberg Kaplan Wolff & Cohen PC’s real estate group, which has an unusual expertise in medical office building development deals.

Read this article about Hospitals Turn To Off-Campus Offices Under ACA

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

Medco Beats False Claims Suit Alleging Kickbacks

Law360, New York (January 02, 2014, 3:30 PM ET) — A New Jersey federal judge on Monday tossed a False Claims Act suit alleging a Medco Health Systems Inc. unit made illegal donations to nonprofits serving hemophilia patients in exchange for referrals to its treatment centers, ruling that the money was not used to bilk federal health care programs.

U.S. District Judge Noel L. Hillman, sitting in Camden, said Medco unit Accredo Health Group Inc.’s goal in making contributions to advocacy groups such as Hemophilia Services Inc. was to enable those organizations to cover the private health insurance premiums of their members and keep those patients from using public benefits, which would’ve hurt Accredo’s business.

Read the full article here:
http://www.law360.com/articles/498224/medco-beats-false-claims-suit-alleging-kickbacks