Ginger Plots Course to Grow Value-Based Business, Break into Medicaid

Ginger, the on-demand virtual behavioral health care system with a $1.1 billion valuation, recently raised $100 million in a Series E funding round led by funds managed by Blackstone Growth. But even more notable than the financing itself is what Ginger plans to do with it — from diving deeper into value-based care to building […]

BayMark, Eleanor Health Among Providers Selected for CMS’s New Value-Based OUD Treatment Demonstration

The Centers for Medicare & Medicaid Services (CMS) has announced the 61 providers that it has chosen to participate in its new Value in Opioid Use Disorder (OUD) Treatment Demonstration.  Starting this month, the four-year demonstration will test whether a new care management fee and performance-based incentive for OUD treatment can reduce hospitalizations and improve […]

Optum Behavioral CEO: We Must Expand the Behavioral Health Care Delivery System to Facilitate Value-Based Care

On average, people with behavioral health conditions cost payers about $875 more per member per month than those without behavioral health conditions. Yet, studies show that less than half of the patients who need behavioral health treatment actually receive it. The health care system’s fee-for-service nature is one reason for that, as is the massive […]

Behavioral Provider Pays $273K to Settle Improper Billing Allegations

A Hartford, Connecticut-based behavioral health care practice and its owners have agreed to a civil settlement with federal and state governments to settle allegations they improperly billed Medicaid. The U.S. Department of Justice (DOJ) announced Tuesday that Maurice Stuckey and Joyce Anderson, as well as their company Today’s Youth LLC, will pay $273,000 to resolve […]

Cigna Doubles Down on Commitment to Virtual Behavioral Health Post-Pandemic

The health insurance giant Cigna (NYSE:CI) is once again doubling down on its commitment to virtual behavioral health care post-pandemic. Like most insurers, Cigna watched its virtual behavioral health claims spike amid the COVID-19 emergency. And Stuart Lustig, Cigna’s senior medical director for behavioral health, told Behavioral Health Business there’s no going back now. “It […]

Lawyers: Biden Unlikely to Expand Parity to Include Medicare, But Other Behavioral Changes Probable

When President Joe Biden was elected, behavioral health stakeholders were hopeful he would tackle some of the industry’s most pressing issues, chiefly among them being parity.  Even though the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires issuers to make behavioral health coverage no more restrictive than medical coverage, payers frequently come […]

CVS Prepares to Launch Behavioral Pilot in 34 New Locations

Pharmacy giant CVS (NYSE: CVS) is releasing more details about the behavioral pilot program it’s rolling out at select HealthHUB locations. Behavioral Health Business first highlighted the pilot in mid-March, shortly after CVS released its annual Health Trends Report and highlighted the ongoing mental health crisis as a factor likely to define health care in […]

Behavioral Providers’ Role in Shaping Post-COVID Telehealth Rules

Telehealth has been vital in helping behavioral health providers navigate the COVID-19 pandemic. Regulatory flexibilities and payer leniency are largely to thank for that, but it’s unclear which of those freedoms will remain in place post-pandemic. Behavioral stakeholders from some of the health care industry’s largest organizations believe that data and provider input should ultimately […]