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5 Medical Cost Pressures Shaping 2018

2017-07-11T18:11:23-04:00By |Financial, Financial Analysis, Health Insurance, Revenue Cycle Improvement, Trends, Uncategorized|

The era of volatile swings and double-digit growth in employer medical costs appears to be ending. With medical cost trend hovering in the single digits for several years, the industry has been waiting for the inflection point when spending will take off. But that spike appears unlikely to happen. The New Health Economy is settling into a “new normal,” typically characterized by more attenuated fluctuations and a single-digit trend.For four years, medical cost trend has hung between 6 and 7 percent, seeming to settle into a “new normal.” PwC’s Health Research Institute (HRI) anticipates a 6.5 percent growth rate for calendar year 2018, half a percentage point higher than in 2017.

Shoveling Money Down Growing Behavioral Health Gaps?

2017-06-13T19:54:09-04:00By |Uncategorized|

Calculating future expenses stresses all managers and directors. In the ever-changing world of healthcare, making the time to accurately budget costs can cause headaches, nausea, dizziness, and palpitations. (Please do not operation heavy machinery while thinking about budgets.) Estimating the financial impact of the growing behavioral health gaps may be the final straw. Today's blog gathers data points from recent studies, reports, and presentations from around the healthcare industry and offers a starting point for your various budget models. Make the time to verify your models are sporting the most current data. Challenge your assumptions, because margins are thin and getting thinner.

Top (and Bottom) 10 States For Behavioral Health Staff Shortages

2017-05-31T20:18:20-04:00By |Behavioral Health Integration, Clinical Operations Improvement, Uncategorized|

The greatest need for mental health professionals are found in the more populated east coast and remote northern states. Large populations and rural settings significantly impact behavioral health staff shortages. The Health Resources and Services Administration (HRSA) released the most current data. The table shows the 10 states with the worst behavioral health professions clinical coverage, the national average, and the 10 states with the best BH coverage.

Levels of Care Impact Medical Necessity Review Success

2017-07-05T17:19:34-04:00By |Accreditation, Services, Uncategorized|

Level of Care Guidelines are usually derived from generally accepted standards of behavioral health practice. These standards include guidelines and consensus statements produced by professional specialty societies, as well as guidance from governmental sources such as CMS’ National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs).

Behavioral Healthcare Shortages: Causes and Solutions

2017-07-05T17:13:36-04:00By |Behavioral Health Integration, Clinical Analysis, Clinical Operations Improvement, Uncategorized|

The National Council for Behavioral Health and the National Council Medical Director Institute released a far-reaching report this month: The Psychiatric Shortage: Causes and Solutions. As a recognized leader in behavioral health reviews, this BHM Healthcare Insider Blog brings selections from the executive summary focusing on the behavioral healthcare shortages and solutions.

Successful Delegation To Downstream Entities

2018-05-23T16:25:27-04:00By |Compliance, Operational Analysis, Uncategorized|

Healthcare organizations face challenges regarding reduction of their medical and administrative costs because regulatory and administrative demands are increasing. Payers and providers must evaluate new partner relationships and solutions for work processes and potentially outsource administrative functions in order to offer competitively priced services to patients. Successful delegation requires planning.

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