IDD and Behavioral health providers want to improve their connection to the healthcare system overall. However, that may bring new issues and challenges to achieve.
We’ve seen trends develop throughout 2018 with varying degrees of impact. More than likely the intensity and cadence of these trends will heighten throughout 2019.
Mergers and acquisitions are expected to continue in the fragmented behavioral health landscape. Private equity firms with platform deals will seek to build out their portfolios more strategically in 2019, looking for smaller targets with potentially lower multiples that will fill service gaps in the continuum of care.
But for-profit isn’t the only sector seeing activity. Given the increasing pressure on Medicaid reimbursement, non-profit organizations are looking to merge or possibly be absorbed.
The need for agency fiscal sustainability is more important than ever.
An easy trap for many agencies is to ignore the actual amount and length of their denials. Typically, our industry experiences a 15-25% denial rate. Many agencies budget at a 20% rate.
For a medium sized agency, that can equate to over $145,000 a month in denials and delays.
What could your agency do with an additional $100,000 per month?
In the continuing battle to reduce denials, most of the errors lie in the human factor.
We all know there are times when we cannot read the client’s handwriting on their intake paperwork or on the doctor’s notes. Typos and missing information continue to be a plague.
A denied claim slows the reimbursement process and hampers the financial sustainability of your agency.
Organizations that wish to improve on their success must take EHR Total Cost of Ownership (TCO) into consideration.
The behavioral healthcare business model is particularly complicated—with ripple effects between providers, payers, technology, and regulation that affect the organization’s bottom line—making TCO difficult to quantify.
The majority of the indirect costs that factor into TCO appear to have one common denominator: legacy software.
Incumbent business solutions lack the adaptability to keep pace with the dynamic business model of behavioral health care, and organizations are having to fill functionality gaps with supplemental training or workarounds, whether additional costs in maintenance or customized releases and, most importantly, forego fleeting opportunities for supplemental revenue.
The good news is several of these aspects of TCO can be mitigated, if not eliminated outright. Modern platform technology enables agencies to rapidly configure workflows, allowing the creation of a robust, yet simplified user experience, while affording the adaptability to stay ahead of changing healthcare regulation.
When it comes to TCO, the devil is in the details. Organizations that wish to bring their TCO down to a manageable level will need to take control of the indirect costs inherent in legacy software by leveraging platform technology.