Acadia CEO Hopeful Pandemic, Biden Will Catalyze Better Behavioral Health Parity

For years, industry stakeholders have decried the health care system’s lack of behavioral health parity.

Federal legislation — starting with the Mental Health Parity Act of 1996 — has attempted to ensure behavioral health services are as accessible and affordable as those in the medical-surgical realm. But various reports show that’s still not the case.

However, some industry leaders believe the coronavirus and the new administration could help change that. The nation is finally paying attention to the importance of mental health treatment, as the pandemic has caused the prevalence of stress, anxiety and depression to rise. At the same time, President Joe Biden, who has long pushed for parity in his policymaking, seems to be making behavioral health a priority.


As such, Acadia Healthcare (Nasdaq: ACHC) CEO Debbie Osteen is hopeful that parity will finally become less of a goal and more of a reality in the years to come.

“[The Biden administration] seem[s] to be looking for ways to support [behavioral health] … not just federally but through the states as well,” said Osteen, who laid out her view on that and other matters affecting her company and the industry overall Wednesday during the 2021 RBC Capital Markets Global Healthcare Conference.

Osteen said she believes that one of the most pivotal moments in the behavioral health parity fight came last year when the Trump Administration mandated that Medicare and Medicaid cover medication-assisted treatment (MAT).


The Medicare mandate came in January 2020, with the Medicaid mandate coming later in the year in October. The rules coincide with a stark increase in the occurrence of substance use disorder (SUD) and overdose deaths the nation saw last year.

“The general climate and focus has been [on] how to support mental health,” Osteen said during the virtual event. “There’s such a dramatic need, and that’s only escalated with COVID.”

Behavioral health has also become a focus of the Biden administration since the president took office in January.

Industry leaders have hailed President Biden as a champion of behavioral health, citing his support of the Mental Health Parity and Addiction Equity Act of 2008, as well as his work to ensure that parity was included in the Affordable Care Act (ACA) of 2010.

During the event, Osteen saluted the Biden administration for its recent work requiring insurance companies and MCOs to report on their compliance with parity laws.

“Seeing that, and having [insurers and MCOs] go through the exercise of showing how they are complying [with parity] is favorable for our company [and] the whole industry,” she said.

Osteen, likewise, spoke highly of Biden’s longtime legislative advocacy for behavioral health.

“I think before the election — and I’ve been pleased to see even after — he’s [been] very supportive of mental health,” she said during the event. “And he’s also very focused [not only] on trying to eliminate stigma, but … enforcing parity.”

Acadia’s telehealth, growth outlook

Acadia is the nation’s largest standalone behavioral health company, operating 227 behavioral healthcare facilities across 40 states and Puerto Rico. Like many other providers, Franklin, Tennessee-based Acadia has leaned more into the use of telehealth, as social distancing measures in some areas temporarily stopped in-person behavioral health services.

Since the pandemic, various waivers at the state and federal level have been relaxed to allow providers to render more telehealth services.

Last year, the Centers for Medicare & Medicaid Services (CMS) broadened its telehealth reimbursements, and according to Osteen, the move has been critical for both her company, and the industry at large, in the absence of in-person assistance.

“Even though there’s [previously] been a lot of discussion about telehealth, the reimbursement was not matching … the dialogue,” Osteen remarked during the event. “What changed with the pandemic is allowing practitioners to offer telehealth in lieu of an office visit, and getting paid for that visit.”

Osteen said that by expanding reimbursements for telehealth, CMS helped pave the way for commercial payers to do the same.

“That was a very positive thing to show that [CMS] saw this issue of people not being able to access [services because of] stay-at-home orders,” she added. “Other payers followed that and were also very supportive of it. I do have to give the [Trump] administration credit for that.”

Also during the virtual discussion, Osteen doubled down on the company’s future plan to add more services, which it has also highlighted on past earnings calls.

In the wake of Acadia’s divestiture of its United Kingdom assets earlier this year, the company has recommitted itself to growth on the domestic front, with service line additions being just one part of that.

For example, it added 92 beds to existing facilities in the first quarter of 2021 — a quarter in which its revenue increased over 8% from Q1 2020. Plus, it currently has about 30 joint venture (JV) projects in various stages with other providers across the country.

“The advantage to working with a [JV] partner … is it allows us to enter a market that’s attractive,” she said during the event. “As we do that, it really has expedited … our opening a facility … . It also helps with [hiring] staff because they also have staff, and we are very open to bringing them on to our partnerships.”

Acadia did close a few of its US facilities in recent months . However, going forward, Osteen said that the company’s primary growth will occur within its acute care services lines in adding more beds. Acadia is also planning to open 11 comprehensive treatment clinics that provide MAT services to patients this year.

“We feel good about what we have, and we want to grow it,” she told event attendees.

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