BHbusiness: Helping Providers Navigate Health
Preventing and treating mental and substance use disorders require more than clinical skills. To be effective, providers must also have excellent business skills. The Affordable Care Act , the Mental Health Parity and Addiction Equity Act, and other changes are making such skills now more important than ever.
"With 2014 fast approaching, behavioral health providers need to be getting up to speed now to make sure their businesses are prepared to cope with the changes full implementation of health reform will bring," said SAMHSA Administrator Pamela S. Hyde, J.D.
The new SAMHSA-funded BHbusiness: Mastering Essential Business Operations initiative will offer targeted training and support to 30 BHbusiness learning networks, each consisting of up to 30 organizations. The State Associations of Addiction Services (SAAS) will administer the project in partnership with the National Council for Community Behavioral Healthcare, NIATx, and Advocates for Human Potential .
"Providers are doing an excellent job in the clinical areas, but many just aren't prepared in the business operations part of this new landscape," said Becky Vaughn, M.S.Ed., Chief Executive Officer of SAAS.
Using a combination of online courses and discussion groups, webinars, individual and small group consultation, and in-person meetings, the learning networks will focus on five key areas:
- Strategic business planning. After conducting market and organizational assessments, participants will create business plans that address expanded access to care, new reimbursement models, and other aspects of the changing environment.
- Third-party billing and compliance. Participants will learn such skills as how to implement third-party billing systems and identify core compliance measures.
- Third-party contract negotiations. Participants will learn how to demonstrate the value of their services and how to market those services to new payers.
- Eligibility determinations. Health reform will expand access to Medicaid and create new state-based insurance Exchanges, so participants will learn how to determine eligibility and get patients enrolled.
- Meaningful use of health information technology. Participants will learn how to take advantage of technology and meet "meaningful use" standards.
In order to demonstrate practical application of the knowledge gained, each provider will also tackle a related organization-specific project as part of the process.
"Research shows that people learn better when they have opportunities to interact and to practice what they're learning," said Kimberly Johnson, M.S.Ed., M.B.A., Co-Deputy Director of NIATx . "We're trying to mix up the online and the in-person and the synchronous and asynchronous, so that people are actively engaged but also have the ability to do things in their time frame, not ours," she said.
Of course, participants will also learn from each other, said Neal Shifman, M.A., President and CEO of Advocates for Human Potential . "One of the advantages of learning networks is the peer-to-peer influence that occurs when like-minded organizations share real-life stories, experiences, and answers about improving their business processes," he said.
Mohini Venkatesh, M.P.H., Senior Director of Public Policy at the National Council for Community Behavioral Healthcare , agreed. "One of the challenges we have with technical assistance is making sure recipients are sustainably implementing practices that will live well beyond the consultation," she said. "Learning networks really facilitate that, because the way they're structured helps cultivate communication."
BHbusiness will target behavioral health providers with limited business capacity to participate in third-party reimbursement networks. Within provider organizations with limited third-party billing capacity, special emphasis will be given to recovery peer support providers and providers serving vulnerable populations. However, use of the BHbusiness curricula will not be limited to providers formally involved in learning networks. BHbusiness will make the curricula available online for public use to ensure the widest distribution possible.