The substance use disorder (SUD) treatment industry is evolving.
Evidence is mounting demonstrating the importance of offering evidence-based treatment modalities, complete continuums of care and hybrid service offerings.
Recovery Centers of America (RCA) is looking to adapt to these changes by prioritizing the integration of its service lines to improve patient outcomes, drive financial performance and prime itself for alternative payment models.
RCA is also focused on enhancing recruitment and retention efforts while looking to expand its geographic footprint into underserved areas, according to Peter Vernig, vice president of mental health services at Recovery Centers of America.
Vernig will be participating in a panel discussion entitled “Outcomes-Backed Innovations in SUD” at Behavioral Health Business’ inaugural Autism & Addiction Treatment Forum in Chicago on July 18.
King of Prussia, Pennsylvania-based RCA has 11 inpatient facilities in Maryland, Massachusetts, Pennsylvania, Illinois, Indiana, New Jersey and South Carolina. Many of its facilities also provide outpatient services through both in-person and telehealth modalities.
Behavioral Health Business sat down with Vernig to discuss patient transitions between levels of care, new treatment models and rapidly expiring telehealth flexibilities.
The transcript below has been edited for length and clarity.
BHB: What would you describe as some of the RCA’s highlights in 2024 so far?
Vernig: We are at the point where we are shoring up some of our clinical processes. A lot of the past two years have been rolling out our care model, refining the treatment that we provide and looking at our service lines and trying to do a better job of integrating them.
Very early on, years ago, in startup mode, the idea was we had to get all of the services that we have stood up and operating. We certainly did that but there was less of a focus on how they really work together.
We are unique amongst a lot of providers in that we have the full continuum of care to offer to our patients, payers and community partners, but we have been looking at how we make sure that that is a truly integrated system and that the transition from one level of care to another is going to be as seamless as possible for our patients and their families. We’re at a point this year where we’re seeing the fruits of those efforts starting to come to fruition. We’re starting to see the benefit of that in our outcomes with patients.
From a business perspective, does integrating services make it easier to keep patients with RCA as they improve?
Absolutely. We certainly think that, as an example, when we have somebody discharged from our inpatient program, we can provide them with some of the best care possible on the outpatient side. We want to keep them in our system. Obviously, as with any organization, there’s a business imperative to do that as well. But we think that it’s a better experience for the patient because they have that continuity of care.
What are some of the challenges that RCA is dealing with?
Our challenges are the same challenges that most people in the healthcare space are experiencing, especially behavioral healthcare, including the increasing costs of labor and the complexity of the system. Since the COVID pandemic, we’ve seen the labor market become a lot tighter, so we’re having to work harder, as everyone is to, to recruit and retain good talent. We have a very strong focus on having the best people provide the best care for our patients and the best value for our partners.
We approach recruitment and retention from a number of angles. First of all, we want to be the kind of place that people want to work. A big part of it is the culture and the support, and providing people with the tools that they need to do their job.
Some of the other ways that we foster a positive work environment providing people flexibility, providing therapists with supervision, providing nurses with the opportunity to receive additional training.
RCA opened a new inpatient treatment center in Greenville, South Carolina in September 2023. What service line is RCA looking to grow next, and what geographic areas might we expect to see RCA target?
The areas we’re already in are what we’re looking at most. We’ve had a lot of success having centers that provide both inpatient and outpatient integrated services. I think that is definitely the future for us – to have that full continuum of care so that we can offer not just one small slice to a payer, community or patient and their family, but we can offer a full integrated service.
Geographically, that’s open at this point. I think we’ve done well looking at areas where this is not the kind of service that people have open to them. A great example is the Greenville area.
Some COVID-era telehealth flexibilities are set to expire at the end of 2024. What do you expect to see happen with these flexibilities?
The drive towards telehealth in the behavioral health field is something that was happening before COVID. COVID obviously accelerated that. To some degree, the genie can’t go back into the bottle. There are a lot of consumers out there that have decided they liked this service. We have been very open to providing that as long as we’re able to provide it. We, and hopefully most providers, are willing to meet patients where they are with that. If somebody wants to come in individually for their outpatient services, we’ll certainly offer that and have that available for them. But we also want to make treatment available to people whose transportation situation, mobility, locality or other life circumstances prevent them from being able to do that.
Any rollback of the ability to provide telehealth services would be met with disagreement from healthcare consumers who have gotten used to being able to receive care in a way that is more convenient, flexible and tailored to their individual needs.
The industry is experiencing a lot of buzz about value-based care and alternative reimbursement arrangements. Are you seeing any shifts in reimbursement structure in the industry or pressure for changes?
We in the industry love to talk about it and have been talking about it for a decade or more. The action or the practice has been slow to catch up to that talk, both on the provider and the payer side. However, we’re starting to see the first steps towards those types of relationships.
The initial steps that have been in place for years are the pay-for-performance type of contracts where there are either bonus payments or an at-risk portion of the contract that is based on performance metrics. Beyond that, we are starting to see payers and benefit managers who are interested in getting into more at-risk contracts where, at the more extreme end, there’s population management where you’re paying for a specific product or grouping of individuals and providing all those services.
One of the reasons why we work so hard to have a full continuum of care is because it allows us to be involved in that type of contracting and those kinds of programs.
Those providers who are only offering something at a certain level of care, if they want to get into those types of programs, they’re going to need to look for strategic partners. If we only offered inpatient, we would probably need to find some outpatient providers that we could work with, and vice versa.
I don’t know what that will look like consolidation or if it will look more like strategic partnerships. In order to really be competitive those providers are going to need to find partners who can provide what they don’t.
What are some major trends that you’re expecting to see in the SUD industry?
One trend is medication for addiction treatment. That’s something that we as an organization have really committed ourselves to – removing barriers for patients to get on life-saving medication for their substance use disorder. Obviously, that’s an individual decision that each patient makes with their provider whether or not that medication or any type of medication is right for them as part of the treatment plan.
Another one is new innovations in treatment models. New models for patients in long-term care. We are looking at some partnerships with organizations that provide things like contingency management or in-home monitoring. We are looking at solutions for problems that maybe have not been proposed before, or that had been proposed, but there have been barriers in place. Now we’re in a spot where we can actually try to approach those.