SAMHSA’s BHbusiness Plus Project for Providers

SAMHSA’s BHbusiness Plus program helps providers implement the necessary business changes to survive and thrive in the new Health Insurance Marketplace.

BHBusiness Plus

SAMHSA’s free BHbusiness program offers facilitated learning networks, self-paced online courses, and resources to educate the behavioral health workforce on:

  • Developing strategic business plans
  • Identifying health information technology (HIT) systems that are eligible for incentives
  • Helping their clients access health insurance

NEW: Self-paced online course, “Eligibility and Enrollment: The ACA, Insurance Eligibility, and Your Business” walks providers through how expansion of Medicaid eligibility and other enrollment changes under the Affordable Care Act (ACA) affects their business operations. Providers who successfully complete the course can earn up to 6.5 continuing education (CE) hours through NADAAC.

The Need for Behavioral Health Care Providers

Before implementation of the Affordable Care Act, the SAMHSA 2010 National Survey on Drug Use and Health (NSDUH) estimated that an additional 30 million previously uninsured people with behavioral health problems would become eligible for coverage.

As of May 2014, the U.S. Department of Health and Human Services estimates that more than 8 million people have selected an insurance plan through the Health Insurance Marketplace, many of whom will need services for mental and/or substance use disorders. Additionally, among the 48 states reporting both June 2014 enrollment data and data from July–September of 2013, approximately 7.2 million additional individuals enrolled in Medicaid and Children’s Health Insurance, a 12.4% increase over the average monthly enrollment for July through September of 2013. Rates of uninsured individuals are expected to continue to drop in the coming years.

To help providers adapt to the changing insurance market, SAMHSA developed and launched BHbusiness in 2012, offering technical assistance and expert coaching and consultation to support behavioral health care provider capability.

How BHbusiness Plus Works

Through facilitated learning networks and self-paced online courses, SAMHSA’s BHbusiness Plus helps providers increase their capacity in eight critical areas:

  1. Eligibility and Enrollment—Providers are offered guidance on how to increase client access to health insurance coverage through more efficient identification and processing. Just released: Self-paced online course, Eligibility and Enrollment: The ACA, Insurance Eligibility, and Your Business. Register now.
  2. Strategic Business Decision Making—Providers explore their organizations’ strengths and weaknesses in the marketplace and identify the best focus for making change.
  3. Exploring Affiliations, Mergers, and Acquisitions—Providers consider various business models from shared administrative services agreements through full mergers of two or more organizations.
  4. Costing Out Your Services—Providers use tools developed by cost accountants and community service treatment providers, and learn principles for assessing the cost of new services or adapting service delivery models to health care changes.
  5. Setting up a Third-Party Billing System—Providers are introduced to necessary steps for setting up a billing system, developing staff skills and confidence, and designing the infrastructure necessary to submit claims for payment from one or multiple payers.
  6. Improving Billing Systems to Increase Collections and Compliance—Providers work on increasing collections rates, speeding up revenue cycles, and increasing the number of units of service allowed by managed care providers.
  7. New Business Planning—Providers are guided in developing a business plan from resource allocation to revenue projections, resulting in a plan for incorporating new customers, payers, or services into the current business model.
  8. Third-party Contract Negotiations—Providers are introduced to the new reimbursement structure and shown how to create an analysis of their local health care market, determine their market value, and attract new payers using sales and marketing strategies.

BHbusiness Plus Resources

BHbusiness Plus now offers public access to many of the resources used in learning networks, including articles, presentations, and practical tools for developing and improving business practices. Interested behavioral health providers can learn more through the BHbusiness Plus Resource Library.

BHbusiness Plus Partners

BHbusiness Plus is funded by SAMHSA and coordinated with the National Council for Behavioral Health.

Last Updated: 06/15/2015