Tag Archives: residential services

The Future of Substance Abuse Treatment

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I just received the attached from Addiction Professional Magazine, which, in my opinion, is a must read about the antiquated system of substance abuse treatment models that are employed and how existing RESEARCH needs to be reviewed and implemented.

Quote: [Integration] is not a gift to the mental health and substance abuse field. We¹re not being given something just because it’s fair, just because it’s our time, or just because there¹s a Democratic administration. You can¹t run the rest of healthcare if you don¹t manage substance use and mental health.

Me: Housing is an integral part of this equation as well. The best treatment outcomes occur when safe and secure housing exists. It’s a human necessity.

This is a great article that discusses Integration:
Integration demands highest standard of care

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Zoning – Cities Can’t Discriminate Against Providers

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Once again (and again, and again), the NIMBY (Not In My Backyard) and the CAVEmen (Citizens Against Virtually Everything) pitchforks came out in mass to protest a methadone clinic opening in Philadelphia, notwithstanding that methadone clinics are otherwise allowed.

“The court also used a Third Circuit finding to bolster its conclusion, citing a 2007 ruling that found that municipalities are not free to hold methadone clinics to different zoning standards than ordinary medical clinics.”

There is no basis to treat medical and health clinics any differently from substance abuse clinics, but for the type of person to be treated.

I often find it comical (not really) when I bring to NIMBY’s attention that a MOD (medical office building) permits psychiatrists who have the right to see would-be mass murderers and potential child molesters, but heaven forbid people seeking recovery and solace from the scourge of drug abuse seek similar (if not less intense) medical and behavioral care, and the pitchforks and torches come off the shelves.

Check out this LAW360 article:
Pa. Court Says Philly Zoning Can’t Preclude Meth Clinics

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Prompt Pay Laws

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Many have been calling in recent days regarding insurance carriers refusing to pay for claims for treatment, essentially saying “sue us for your money.” Aside from potentially discriminatory undertones, this is patently illegal.

The State of Florida has what are known as “Prompt Pay” laws which require an insurance carrier to do just that. While I won¹t get into the details here, I thought I would share this article with you to illustrate that ³you are not alone² when it comes to this headache.

Read more about them with Law360’s article:
Hospitals Can Sue Under Prompt Pay Law: NY Appeals Court

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OIG’s 2014 plan promises scrutiny for behavioral health

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By Dennis Grantham, Editor-in-Chief of Behavioral Healthcare

In a recent story, “Compliance programs stress effectiveness” (Behavioral Healthcare, Nov./Dec. 2013 issue), Fabio van der Merwe, director of quality improvement and compliance at DeKalb Community Services Board (Atlanta, Ga.) noted that each year, the Office of the Inspector General (OIG) for the Department of Health and Human Services releases an annual work plan.
This plan, he says, “puts compliance officers ‘on notice’ as to the focus of federal Medicare and Medicaid enforcement activity for the coming year.” In its recently unveiled 2014 work plan, the OIG committed to continuing a range of investigative activities involving behavioral health.

Read the full article here.

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Further Discussions on the Marketplace Impact of the Affordable Care Act

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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

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Shifting Away from Fee for Service Towards Coordinated Care Payment Models

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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

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Payment system among the unconventional aspects of treatment center in Michigan

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Best Drug Rehabilitation offers flat rate for residential services.

A northern Michigan residential treatment program that offers customized faith-based curricula and daily scheduled exercise periods also looks different from many other centers on the payment end of the business. Administrators decided when they opened Best Drug Rehabilitation last November that they would identify one flat payment rate for services, regardless of length of stay in the largely self-pay program.

Read the full article here:
http://www.addictionpro.com/article/payment-system-among-unconventional-aspects-treatment-center-michigan

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