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 […]
Category: Reimbursement
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. […]
State Medicaid programs across the nation will continue to make behavioral health a strategic priority in 2025. A new survey report released by the Kaiser Family Foundation (KFF) found that half the state leaders of the joint federal-state health plan for the vulnerable want to expand the continuum of behavioral health services in their states, […]
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. […]
A Florida federal court ruling issued last month could lead to a “massive sea change” in what lawsuits can be brought against behavioral health companies. That is the interpretation of Gregory Jones, a principal at the law firm Polsinelli’s Los Angeles office, who represents health care companies, including in False Claims Act (FCA) cases. FCA […]
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 […]
Companies that treat opioid use disorder could commend themselves last month when the federal government reported overdose deaths were down nearly 11% for the first eight months of 2024, marking the second-straight year of decline. “It’s fantastic news,” Jason Kletter, president of BayMark Health Services, told Addiction Treatment Business. “It’s something to celebrate.” But the […]
Youth behavioral health residential treatment facilities could face more scrutiny following additional public pressure by a powerful federal lawmaker. On Wednesday, Senate Finance Committee Chair Ron Wyden (D-Oregon) publicly called on the U.S. Department of Justice (DOJ) to investigate four major behavioral health providers to determine if their youth residential treatment programs committed Medicaid fraud. […]
Opioid use disorder (OUD) disproportionately impacts Medicaid beneficiaries, yet structural barriers – including lack of available clinicians – often keep this population from receiving treatment. Virtual OUD treatment provider Ophelia has expanded its Medicaid reach by inking new reimbursement contracts that cover the lives of 3 million New Jersey residents. “We’ve been live and treating […]
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