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Outcomes will Determine Income: The Impact of Shifting Reimbursement on Behavioral Health

Wednesday, January 27, 2016, 1:00 p.m. ET, 12:00 p.m. CT

Dr. Bill Bithoney will review the tectonic shifts in reimbursement for Behavioral Healthcare under the Affordable Care Act.  He will also discuss the clinical requirements which insurers and CMS are putting in place in order for BH organizations to receive reimbursement for the care they provide. In the future, insurers will only pay for care which is “evidence based.” Of interest and import is that there is a strong movement afoot to pay for proven telemedicine-based care as well as computerized interventions based in cognitive behavioral therapy.  Dr. Bithoney will also discuss the movement to so-called “Value Based Care” wherein patient outcomes and measured quality metrics will have a major impact on provider payment and overall income. 

In this webinar, Dr. Bithoney will also review the recent increase in merger and acquisition activity in the field.

Learning Objectives:

  • Understand regulatory changes affecting reimbursement for substance abuse and behavioral health programs
  • Review the latest medical research on substance abuse and process disorder treatment
  • Review the current market environment for mergers and acquisitions in the BH field given changing reimbursement models and value-based purchasing
About the Speaker(s): 

Dr. Bill Bithoney, MD, FAAP Managing Director, Chief Physician Executive at BDODr. Bill Bithoney has over 20 years experience serving as a physician executive in diverse academic and hospital systems, specializing in developing ACOs, physician alignment, managed care, academics, and performance and quality improvement. He worked for nearly 20 years at Boston Children’s Hospital/Harvard University School of Medicine. He also served as Vice Dean of NY Medical College. Dr. Bithoney has advised on ACO and physician alignment strategy for Signature Health System and UMass Memorial Health Care in their Medicare Advantage program. At Sisters of Providence Health System (SPHS), he served as interim president and chief executive officer, as well as chief operating officer and chief medical officer. Following the successful transition to an ACO, he and his team turned SPHS into the most profitable community hospital in Massachusetts, despite being in the most impoverished city in the state.In 2010, Dr. Bithoney and his team won the Innovation Award from the American College of Healthcare Executives for their ACO work managing a healthcare system and an award winning full-risk cap MA program. Additionally, SPHS was named one of the Top 100 Hospitals in the US for quality and value by Cleverly and Associates in 2010, 2011 and 2012.