Behavioral health and addiction treatment professionals fear changes to the Affordable Healthcare Act (ACA) will have dire consequences for the most vulnerable. Many are worried that abolishing the individual mandate will trigger dramatic premium increases as more young, healthy people opt out of buying insurance. Escalating premiums and fewer healthy exchange participants may stress the fragile marketplace even more, eventually leading to heightened uncertainty or total collapse.
Medical data, specifically personal health information, including names, addresses, and social security numbers, drive a black market worth millions, potentially billions of dollars. The US Department of Health and Human Services confirms 50 significant data breaches already in 2018, and it is only March. Hackers gained access to more than 300,000 medical records via ransomware, unauthorized access/disclosure and theft or loss of equipment.
Providers are finding challenges with health information exchange or HIE. There are still hurdles that providers face when trying to exchange information on patients. Nonetheless, the exchange does not need to be complicated. Solutions exist that can help create a streamlined sharing of information between medical practitioners, administrators, patients and other parties.
Many treatment centers, both for-profit and not-for-profit, have discovered that onboarding an experienced Utilization Review Coordinator bridges the gap between Admissions, Accounting, and Clinical departments. Having a trained staff member that can interact with a payer and provide documentation of medical necessity is one of the wisest staffing decisions a facility can make. If you are frustrated with poor results from having an outside billing company fill these shoes consider what it takes to have that person on staff. This does not mean you have to do your own billing, but it does pave the way to control a bit more of the outcome.
Are mountains of paperwork contributing to high staff turnover rates and exhaustion for loyal team members? Studies show inefficient workflow within the clinic may produce burnout symptoms, even if you have a great reward package and an otherwise supportive company culture. Every therapist knows that emotional exhaustion manifests itself in myriad ways, including the dehumanization factor which puts clients at risk, too.
Tackling Two Crisis Points Simultaneously
In September 2017, the Health Resources and Services Administration (HRSA) released more than $200 million to encourage healthcare providers to tackle the opioid crisis head-on. This financial incentive to improve access to treatment and recovery services include funding for providers expanding or implementing new telemedicine offerings.
In the U.S. alone there are over 20,000 overdose deaths related to prescription pain relievers, and almost 13,000 related to heroin, making drug overdose the leading cause of accidental deaths. Opioid addiction is driving this epidemic with approximately 91 daily deaths. As addiction rates have reached epidemic proportions nationwide, payers, providers, and patients are struggling with finding a compelling solution.
If you own or manage an addiction treatment center, do not make the mistake of purchasing a generic electronic medical/health record software! Addiction treatment and behavioral healthcare professionals have a unique workflow. Your EHR needs to support this process and be designed to fulfill your everyday needs.
After participating in an addiction treatment program, it can be difficult to go back to normal life with its stressors, triggers and access to substances. In many cases, participants attended the program for a short period of time and have not fully addressed addiction-related problems. Many people end up facing relapse, but this is where an aftercare program can help. To support patients as they continue with recovery, facilities and programs can provide routine check-ups as an aftercare program. This helps people feel supported and keeps them accountable.