The days of behavioral health operators providing a single service may be numbered. Today, many payers and patients prioritize providers with a full continuum of care that can meet various needs.
Making a behavioral health provider a one-stop shop can mean providing patients with a comprehensive range of care options to access higher and lower acuity services. It can also mean integrating physical and behavioral health care.
Offering multiple service lines isn’t just about enriching the patient experience; it can also be a prudent business decision for providers.
“Diversification of revenue is always a smart strategy so you don’t have all your eggs in one basket. But for clinical continuity of care, you want to have a system where folks can move through it,” Stacy DiStefano, CEO of Consulting for Human Services (CFHS), said at Behavioral Health Business’ VALUE event. “And they don’t have to go back and forth to different providers. It’s also attractive to payers, so they don’t have to have multiple sources of touchpoints. And there is no wrong door for patients to enter.”
CFHS is a behavioral health-focused consulting firm that works with nonprofit provider organizations, payers, state systems, tech vendors, and private equity firms.
Many patients with behavioral health concerns move up and down the care continuum as they progress through care. Additionally, many have comorbidities that also need to be addressed.
To meet the diverse needs of patients, payers are often receptive to providers with more levels of care.
“We’ve moved into the continuum of care pretty aggressively. It’s been part of the owner’s business model, which I have continued since I came on board about two years ago. But for us, it’s also the ability to have more relevance with our payer partners,” Drew McCartney, CEO of Praesum Health, said at VALUE. “So our ability to follow that patient’s economic and clinical journey, as they move through care makes us much more relevant to payers.”
Florida-based Praseum operates 32 facilities across six states. Its services include detox, inpatient, counseling and residential care. It operates on a managed services organization (MSO) model.
Physical and behavioral health integration
While providing many levels and types of behavioral health care is today’s hot topic, the next move is integrating physical and behavioral health. More and more primary care providers are integrating behavioral health services, but there’s a case for the reverse. This is especially true if patients are more comfortable in a behavioral health setting.
“So you’re bringing the primary care doctor into your behavioral clinic… you’re bringing [care to] where the folks are most comfortable. When you try to force the other way, I think you don’t have as much adoption because if you’ve ever been in a [primary care doctor’s] waiting room, it’s chaotic, there’s wait times, there’s things that folks can’t tolerate with severe mental illness. So there’s much better adoption on that reverse integration side.”
Many behavioral health providers who are still hammering out what becoming a one-stop-shop for primary care could look like have turned to a partnership model.
“We have not yet taken that step of integrating primary care into our organization,” Mark Peterson, CEO of Nystrom & Associates, said at VALUE. “However, we have developed collaboration and partnerships with health systems in a number of areas where we have embedded staff in those health systems, often social workers, somebody who can help facilitate the coordination of referrals. And I would say that’s actually been very successful. It’s been a good referral source for us.”
Nystrom & Associates has a wide variety of services including therapy, psychiatry and substance use disorder treatment across a spectrum of severity. It has more than 1,800 employees and 60 locations.
Challenges
While offering more service lines may seem like the way of the future, these expansion efforts can be challenging.
“Even if you have all of those services embedded in the organization… coordination and communication are even more challenging there,” Peterson said. “In psychiatry, you actually can get paid based on the amount of time you spend [on a patient], and you can use some of that time to coordinate care. That’s not true in therapy generally. So I think our clinicians struggle, even in an environment where we foster [coordination].”
Additionally, providers that have historically been single-point solutions may need to adjust to referring patients up and down the care continuum within their organization.
“When you have a full continuum of care, you’re moving patients through your ecosystem regularly. But that wasn’t always natural inclination,” McCartney said. “So we had to break down some of those barriers.”
Companies featured in this article:
Consulting for Human Services, Nystrom & Associates, Praesum Healthcare Services
