SAMHSA’s BHbusiness Plus program helps providers implement the necessary business changes to survive and thrive in the new Health Insurance Marketplace.
SAMHSA’s free BHbusiness program offers facilitated learning networks, self-paced online courses, and resources to educate the behavioral health workforce on the following:
- Developing strategic business plans
- Expanding partnerships, contracts, and other strategic alliances
- Helping patients access health insurance
- Using the latest technology to streamline billing and operations
New in 2015, BHbusiness offers self-paced online courses that allow behavioral health providers to learn about a variety of business operations topics at their own pace. BHbusiness is also offering learning networks to connect behavioral health professionals with subject matter experts to explore practical implementation questions.
The Need for BHbusiness
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 that time period. 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. BHbusiness Plus is funded by SAMHSA and coordinated with the National Council for Behavioral Health.
Through facilitated learning networks and self-paced online courses, SAMHSA’s BHbusiness Plus helps providers increase their capacity in nine critical areas:
- Eligibility and Enrollment—Providers are offered guidance on how to increase client access to health insurance coverage through more efficient identification and processing.
- Strategic Business Decision Making—Providers explore their organizations’ strengths and weaknesses in the marketplace and identify the best focus for making change.
- Exploring Affiliations, Mergers, and Acquisitions—Providers consider various business models from shared administrative services agreements through full mergers of two or more organizations.
- 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.
- 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.
- 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.
- 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.
- 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.
- Planning for the Next Generation of Health Information Technology (HIT) — Providers learn the latest trends in HIT as well as government policies (including the HITECH Act and meaningful use), and how you can adopt the latest HIT in your organization
Learning networks connect behavioral health professionals with subject matter experts over four months to review a mutual topic of interest, discuss challenges and opportunities as a group, and allow providers to explore practical implementation questions. Learning networks typically consist of 8-12 provider organizations and one coach. Participants in learning networks gain access to topic content modules, convene for regular group calls, and have access to the coach and subject matter experts for individual assistance.
In addition to the nine topics above, providers who have a defined goal for changing an aspect of their operations may also join an Implementers Network, which allows providers to work with one of our experts to create a change plan. The Implementers Network follows the same four month time frame as the learning networks, but includes more individual coaching sessions.
There will be three rounds of learning networks in the 2015-2016 fiscal year.
Round 1: November 2015 - March 2016 (Apply by October 16, 2015)
Round 2: February 2016 - June 2016 (Apply by January 15, 2016)
Round 3: April 2016 - August 2016 (Apply by March 18, 2016)
In 2015, BHbusiness is offering self-paced online courses to allow behavioral health providers to learn about a variety of business operations topics at their own pace. Each course offers a series of modules, provides case studies from real providers, and suggests helpful tools to support providers in implementing change.
Hosted on the HealtheKnowledgeplatform, the courses may be accessed at no cost, or providers may pay a small fee to receive continuing education credit from NAADAC.
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.