Medicaid

Post PHE: The State of Medicaid

by

The end of the Public Health Emergency for COVID-19 (PHE) this spring, combined with rising inflation and economic uncertainty in 2023, has changed the dynamic for Medicaid enrollment and funding, particularly at the state level. Medicaid, which is funded jointly by the federal government and states, is the single largest payer for mental health services … Read more

Mental Health Parity at a Crossroads | Streamline Healthcare

by

Report: Mental Health Parity at a Crossroads as 1-4 Have Unmet Behavioral Health Needs “More than 25 years after the first federal mental health parity protections were put in place, adequate coverage for behavioral health care – including both mental health and substance use conditions –remains elusive for many consumers with health insurance.”That’s the conclusion … Read more

Establishing “Payviders” in Behavioral Health

by

One growing trend in the business side of healthcare has been the combination of payer organizations and healthcare providers to create entities known as “payviders.”  The idea of a payvider first originated in the 1990s. Some longstanding examples of payviders include California-based Kaiser Permanente or Pennsylvania-based Geisinger Health System. Other payviders have emerged in recent … Read more

How the Coronavirus Response Spending Bill Will Affect Telehealth

by

President Donald Trump signed into law the “Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020” on Friday, March 6, after it passed the U.S. Senate by a vote of 96-1. This bill provides $8.3 billion in emergency funding to help U.S. researchers and healthcare providers address the outbreak of COVID-19.

Read more

State Reporting for Behavioral Health: Deciphering the Alphabet Soup

by

If your behavioral health agency is using an electronic health record (EHR) system to measure outcomes and report data, you know that there are numerous reporting techniques.

Payers like Medicare, Medicaid, and private insurers use these reporting techniques to measure client outcomes. This allows the payer either to provide bonus payments under incentive programs, or withhold payments for undesirable outcomes. In this way, healthcare systems are migrating from fee-for-service (FFS) to value-based payment (VBP) models.

Different reimbursement programs require different types of reporting. Unfortunately, the “alphabet soup” of acronyms for different reporting methods can be confusing and overwhelming. Let’s decipher some of these reporting types.

Read more