State Medicaid programs and their managed care organization (MCO) partners are amenable to value-based care contracting. However, misconceptions remain as the industry navigates the early stages of value-based care adoption. This openness allows companies to come to the table with new or different approaches to contracting, opening the door to escaping the fee-for-service paradigm. “The […]
Almost 90% of opioid use disorder (OUD) treatment provider Groups Recover Together’s new payer contracts included a value-based care element. This starkly contrasts the vast majority of SUD providers, which still use the fee-for-service model. Value-based care can align payers’ and providers’ interests, encourage providers to provide the most effective pathways to treatment and result […]
A slew of states are pursuing Medicaid coverage for incarcerated populations ahead of their release from prison as a means to address substance use disorders. In Jan. of 2023, California received federal approval to provide people in correctional facilities with Medicaid services before their release. One year later, a “groundswell” of other states seek to […]
The substance use disorder (SUD) treatment industry is beginning to move away from an abstinence-only approach to care toward harm-reduction and medication-assisted treatment approaches. Research demonstrates that abstinence-based SUD treatment is deadlier than no treatment at all. Despite shifts in the industry away from a concept of recovery that involves strict abstinence, providers say that […]
Stephanie Strong founded Boulder Care in 2017 with an ambitious goal: build a profitable substance use disorder (SUD) treatment business that would also accept Medicaid patients, many caught up in the opioid epidemic. Strong’s timing proved auspicious. Over a year later, a new federal law came into effect requiring states to cover federally approved opioid […]
Medications like methadone and buprenorphine have become the gold standard for treating opioid use disorder (OUD). But many people with OUD still receive abstinence-based treatment or no treatment at all for the chronic disorder. And people with OUD who receive abstinence-only treatment are more likely to die than people who receive no treatment at all, […]
Payers and providers have struggled to draw out a roadmap for value-based care in addiction treatment. As a result, the adoption of value-based contracting in substance use care remains low. Still, some payers and providers blazed the trail over the past several years, highlighting some core do’s and don’ts for value-based care contracting. “I’ve been […]
The 5th episode of the Behavioral Health Business Perspectives podcast is now available! For this episode of BHB Perspectives, we caught up with Cooper Zelnick, chief revenue officer at Groups Recover Together. During the conversation, Cooper breaks down Groups’ approaches to value-based care, geographic expansion and Medicaid redeterminations. Listen to this episode of Perspectives to […]
Within the behavioral health sector, it has been a bumpy 12 months for autism treatment providers. But it’s turning out to be somewhat of a tumultuous year for those in the substance use disorder (SUD) space as well. SUD dealmaking fell below pre-pandemic levels in Q1, according to a recent report by M&A advisory firm […]
Value-based care efforts in managed care that involve behavioral health could lead to better savings and health outcomes across entire populations. But to get there, payers should expect to spend more on behavioral health, and providers should expect to increase patient engagement. “There’s been a point of recognition that more behavioral health care is better,” […]
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