Behavioral health’s odd-duck status requires a unique approach to the payer-provider dynamic. Historic challenges have demonstrated that payer-provider negotiations and partnerships require an approach fundamentally different from other types of business, even other health care segments. Often, involved parties need to alter their expectations to reflect reality instead of a vision of the future. For […]
The ongoing need for behavioral health services will be no surprise to anyone involved in the industry. Patients continue to have high rates of need and often present with greater acuity. This demand for behavioral health services was reflected across payers’ Q3 earnings calls. The result? Sky-high utilization levels. For example, David Cordani, the CEO […]
Virtual pediatric behavioral health provider Fort Health is executing its partner-first, expand-after strategy, securing a round of funding while landing a new payer partnership. The New York City-based provider raised a $5.5 million round led by venture capital firms Twelve Below and Vanterra, Fort Health exclusively told Behavioral Health Business. The funds will be used […]
LifeStance Health (Nasdaq: LFST) is overhauling its facilities with a new operating model — one that it hopes will strengthen its position ahead of what executives expect to be a rocky 2025. The outpatient mental health giant’s executives project that federal reimbursement rate cuts will challenge the company’s financial progress. LifeStance is banking on momentum […]
Outcomes data has been touted as both the key to value-based care and the best leverage SUD providers have in payer negotiations. A handful of providers are seeing that in reality: Some payers are becoming amenable in negotiations when outcomes data is on the table, industry insiders said at the Behavioral Health Business INVEST conference. […]
The National Quality Forum (NQF) has partnered with a coalition of health plans and the national digital therapy enablement platform Headway to create a new assessment tool that standardizes how behavioral health clinicians measure the progress of care. The behavioral health industry, across specialties, has struggled with a lack of a standardized data measurement set. […]
Payers don’t lose. That’s been true in the health care space for, pretty much, forever. But I’m tracking a handful of developments that kick at discrete moments of accountability for health plans. The health insurance industry is a land of leviathans. Today, there are four, maybe five, companies that truly matter in the grand scheme. […]
The substance use disorder (SUD) treatment industry was formerly dotted by small, local providers. In the future, these mom-and-pop providers may go the way of cottage businesses during the Industrial Revolution. To be clear, SUD treatment has not yet been completely limited to assembly lines. Small providers still abound. At the recent Behavioral Health Business […]
Until recently, adolescents only had two treatment options for depression. Transcranial magnetic stimulation (TMS), approved by the Food and Drug Administration (FDA) for adolescents in March, now represents a safe and effective third option. While TMS is relatively expensive compared to treatment modalities like pharmaceuticals, payers are increasingly covering the service for teens. Health Care […]
The rollout of the final parity rule feels like a much-needed win in an industry that has been muddling through ever-increasing challenges for years. That’s as long as the final rule goes unchallenged in the courts, of course. Savoring this positive regulatory development is important: Behavioral health professionals need to find proverbial rays of sunshine […]
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