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NAATP: Consider emerging operational issues

May 23, 2017
by Julie Miller, Editor in Chief
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In the larger healthcare system, addiction providers have a unique position among the specialty segments. A panel of treatment center CEOs shared their insights on several emerging operational issues at the National Association of Addiction Treatment Providers (NAATP) annual conference on Monday.

1. Case management and care coordination will become more important.

Unfortunately, treatment centers are paid for remission—not for recovery, said Jay Crosson, CEO of Cumberland Heights. Engaging patients in continuing care plans will remain a challenge.

“We learned that recovery is a life-long process, and we have to do more,” he said. “Third-party payers are behind curve in this regard.”

Cumberland Heights has a team of seven recovery care advocates that meet with patients prior to the transition to outpatient and create a long-term plan for primary care, aftercare and 12-Step meetings. Crosson said the timing is critical to optimize patient engagement.

2. There is a significant shortage of clinicians that must be addressed immediately.

Debbie Sanford, CEO of Pine Grove Behavioral Health, suggested that there is a growing need today for clinical professionals who can treat co-occurring disorders. Executives must look for ways to recruit more people into the behavioral health field overall.

“People do not go into this field unless they have a personal experience with it. That needs to change,” she said. “We need to grow this field among people who don’t know about it personally.”

She suggested career days and possible adjunct positions at universities to help encourage young people to consider a behavioral health career.

3. There is a need for increasingly tailored programs for special populations.

Becky Flood, CEO of New Directions for Women, said being better and doing more must be the new mantra for treatment center leaders. She has observed, for example, that women respond better to treatment when they are engaged in gender-specific programs.

“When women get to us, they are sicker and more damaged from the disease,” she said. “They also get sicker more quickly, while using less [of their substance of choice] than men do.”

Flood also suggested that more care resources must be dedicated to pregnant women, regardless of which trimester they might be in. Some programs are reluctant to treat women in later stages of pregnancy, but their care is just as critical, she said.

4. Behavioral health will increasingly be treated in the health system space.

Ray Tamasi, president of Gosnold on Cape Cod, said behavioral health has a new role to play in the larger health system as value-based purchasing gains traction. Clinicians will be pivotal in helping other medical/surgical providers maintain accountable care goals and earn their favorable reimbursement for comprehensive care models.

“For my money, behavioral health is all moving into the healthcare system,” he said. “There are healthcare systems that are developing their own capacity to deal with these patients now.”

Tamasi noted that a number of Gosnold clinicians are embedded in their local healthcare sites, serving patients in primary care and emergency rooms. The program has been so successful, with 70% of patients seeking specialized treatment, it will be expanding in the coming weeks.

5. Leaders must engage in constant reassessment.

Thomas Britton, CEO of Gateway Foundation, said infrastructure can help make an operation more effective and efficient. Technology and electronic health records can offer advantages, but don’t forget to tap into the knowledge and perspectives of key staff members, too.

”No matter how long you’ve been there, do an environmental scan with fresh eyes or bring someone in to do it for you,” he said.

He advises executives to consider finding internal mentors, even among the people that report to you.

6. Medical tourism represents a growing market.

Denise Bertin-Epp, CEO of Crossroads Antigua, said a number of factors, including cost, have contributed to the emergence of the medical tourism market. Some patients from North America are seeking quality care in other countries—sometimes paying just 10% of what care in the United States might cost.

There’s a large market—as much as $32 billion not including behavioral health—and it represents a new facet of competition. One critical issue is the difference in treatment oversight.

“It’s unregulated, and it’s frightening,” Bertin-Epp said. “There’s no HIPAA law.”

As many as 40% of the patients at Crossroads Antigua come from the United States, she said.