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Preparing for the ACA: Virtual learning teams will convene

February 27, 2013
by Gary A. Enos
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Hundreds of addiction and mental health treatment agencies eager to understand how the Affordable Care Act (ACA) could alter their business operations will begin forming virtual learning communities next month, with many starting with a course in strategic business planning.

Thirty-nine organizational applicants and 650 individual treatment agencies applied to be part of the first wave of activity under an initiative called BHbusiness: Mastering Essential Business Operations, says Kim Johnson, co-deputy director of the behavioral health quality improvement collaborative NIATx. Partnering in this effort are NIATx, State Associations of Addiction Services (SAAS), the Substance Abuse and Mental Health Services Administration (SAMHSA) and Advocates for Human Potential. SAMHSA funded this initiative as a one-year contract with four one-year renewal options.

Johnson says the keen interest expressed in strategic business planning, one of five courses that will launch in March or May, tells her that many treatment organizations remain at a very early stage of assessing health reform’s expected impacts on their business. She adds that it is also true that many addiction and mental health treatment agencies already have rewired operations significantly to reflect expanded access to behavioral healthcare services in 2014, but “there are not a lot of people in the middle,” she says.

Curriculum highlights

BHbusiness will get started in March with learning networks for strategic business planning (with a focus on analysis of local healthcare markets) and third-party billing and compliance (including improvement techniques to boost collection rates). Most of the ideas to be communicated in the courses will occur online through pre-recorded lectures, articles, and other material, and there also will be opportunities for phone and e-mail coaching for participants.

Johnson says instructors will include representatives of the sponsoring organizations, business school faculty from the University of Wisconsin, and a number of consultants. Also as part of the work in BHbusiness, participants will apply a new concept to effect a change in their organizations.

Johnson says the participating organizations reflect the diversity of mission, target population and payer mix seen in the behavioral health provider community. It is her impression that more addiction treatment agencies than mental health agencies signed up to participate this year.

She adds, “SAMHSA really wanted us to focus on organizations that could benefit from Medicaid expansion. We did reach that group of providers.”

In May, the initiative will roll out learning networks for negotiating contracts with third-party payers (exploring a variety of new reimbursement options); eligibility and enrollment (processes for increasing client access to Medicaid or private insurance coverage) ; and meaningful use of health information technology (including the implications of adopting an electronic health record) .

Network composition

Johnson says the 39 “convening organizations” that applied to participate in the initiative include state substance abuse and mental health authorities and state associations representing treatment providers. Individual applicants likely will participate jointly with other providers from their state, and organizers are in the process of grouping smaller organizations with others so as to encourage a collaborative learning environment.

While a number of staff members at the individual organization level will likely take part in and benefit from the courses, “The CEO of the organization is the applicant,” says Johnson. “We’ve communicated that they really need to be the champion.”

The CEO’s direct involvement likely will be critical for the course on strategic business planning, as would that of a representative of an organization’s board of directors.

Participation is free of charge to the provider organizations, but the investment of time will be considerable. “To do it well, it’ll take time,” Johnson says. But the stakes are high for organizations that through the ACA could find opportunities to serve populations for whom addiction and mental health services have remained out of reach in the past.

For organizations that did not apply to participate this time, it is likely that there will be a second round announced later this year, and possibly even some space open in the courses that will debut in May, Johnson indicates. For more information about BHbusiness, visit