As Congress works to finalize its budget reconciliation package, changes to Medicaid are at the forefront of discussions. Leadership in the U.S. House of Representatives has continued to affirm that the Medicaid policies under consideration ensure that no “deserving” Medicaid beneficiary will lose coverage for which they are legally eligible; instead, they have expressed their […]
This is an exclusive BHB+ story Increasingly, employers are paying for addiction care for their staff, disrupting the status quo. It’s changing the way providers view reimbursement and how they operate by placing new expectations on measurable results, transparency and speed. By stepping into the payer role, employers are reshaping stigma, return on investment and […]
Over the past decade, value-based care has transformed primary care and other physical health specialties. When providers are supported and aligned around shared goals, outcomes improve, innovation accelerates, and patients benefit. The results speak for themselves: In 2022 alone, the Medicare Shared Savings Program (MSSP) generated $1.8 billion in gross savings, with over half of […]
Roughly 80% of users who sign up or start the registration process for Teladoc’s (NYSE: TDOC) direct-to-consumer mental health platform, BetterHelp, never become active users. Teladoc CEO Chuck Divita, attributes the drop-off to the cash-pay nature of the business. “The consumer has been under a lot of pressure,” Divita said during a presentation at the […]
This is an exclusive BHB+ story Tobacco cessation services often rank low on the list of offerings for substance use disorder providers. Still, there could be a business opportunity to expand offerings in this space. Tobacco use is still the leading cause of preventable death in the U.S., responsible for just under half a million […]
It may seem contradictory to start on the opposite side of the spectrum from the payment model you aim to move into as a provider, but the best way to shift to value-based contracts could actually be embracing fee-for-service arrangements. Starting with fee-for-service models can help de-risk the transition to value-based care while helping providers […]
As the Trump administration continues to redefine priorities and research around autism, keeping the industry on edge, other pressure points for providers and investors are also mounting in 2025. Network tightening, payer scrutiny, complexity in authorizations and uncertainty in staffing are creating hurdles for reimbursement negotiations, industry leaders explained at the Autism Investor Summit in […]
There is an eagerness across the behavioral health industry to transition from fee-for-service into value-based contracts. But, at times, this urgency can actually be a hindrance instead of a help, industry insiders recently explained at the Behavioral Health Business VALUE conference. Crafting value-based care infrastructure, understanding how and what to measure and defining the mechanisms […]
There’s a strong case to be made that the payer and reimbursement landscape for substance use disorder (SUD) treatment providers is the most challenging in all of behavioral health care due to several deeply entrenched and overlapping issues. For starters, SUD treatment has, in the past, been viewed as less legitimate than other forms of […]
In the early hours of Thursday morning, the U.S. House of Representatives passed the One Big Beautiful Bill Act after approving an amendment intended to mollify opponents to the bill, especially on the Republican side of the aisle. The changes include moving up the rollout of federal work requirements for Medicaid, among other tax-related reforms. […]
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