Comments for Behavioral Health Today

Comment on IOM’s Recommended “Essential Health Benefits” Risk Minimal Behavioral Health Benefits by Patrick Gauthier

Patrick Gauthier — Mon, 14 Nov 2011 18:45:41 +0000

Thanks Maggie. I am not sure when the final regulations are expected with regard to Essential Health Benefits but can tell yyou that the Coalition for Whole Health has put together an excellent resource defining Essential Behavioral Health Benefits. That kind of direction is critical especially where Substance Use Disorders are concerned.

Comment on New Illinois Parity Law Recognizes State Funded Addiction Treatment Providers by Addiction Treatment Forum | New Illinois Parity Law Recognizes State Funded Addiction Treatment Providers

Fri, 30 Sep 2011 15:23:12 +0000

[...] http://behavioralhealthtoday.com/2011/08/29/new-illinois-parity-law-recognizes-state-funded-addictio... [...]

Comment on ASAM Redefines Addiction as a Chronic Brain Disorder – More Medicalization on the Horizon? by Dr. Suka Chapel-Horst

Dr. Suka Chapel-Horst — Thu, 08 Sep 2011 20:57:43 +0000

Of course medicine will gravitate to an increase in the use of medications, a fact that will please the pharmaceutical industry. The truth is that there have been successful recovery programs treating this neurological condition with all-natural food supplements and healthy nutrition for thirty years. We knew about the cause of addiction thirty years ago. Our recovery rates have been averaging between 74% to 85%. AMA and ASAM need to get real and investigate holistic recovery that has a successful track record.

Comment on Behavioral Health Recommendations for Accountable Care Organizations by Patrick Gauthier

Patrick Gauthier — Fri, 02 Sep 2011 17:49:19 +0000

Hi Fran. Great questions. Some brief but pointed answers:
1. How will CMS enforce ACO mandates? Primarily, CMS will use contractual terms and conditions to enforce the model. ACO contracts will be contingent upon performance in a number of critical areas such as: the ability to support necessary infrastructure; to meet access to primary care thresholds; to meet financial requirements; to satisfy outcomes and quality performance metrics; and to comply with reimbursement policies (expect reimbursement reforms, close auditing, and models like Global Payment). Because ACOs are slated for Medicare Shared Savings programs, they will continue to be monitored by Medicare officials, contracted financial auditing firms, and the likes of Medicare QIOs.
2. Is there any private funding to support development? Yes. There are examples of community foundations, Blue Cross/Shield foundations, private foundations, and others like the Commonwealth Fund that are supporting development from a number of different angles.
3. We have many senior consultants who have experience with integration efforts and initiatives. Much of the work of AHP, Inc. has been around transformation under contract with the Federal government, many of our partners are managing such projects today, and – importantly – the advent of ACOs is new so very few people can site examples of actual ACO experience. The truth is, actual models like Kaiser, the Cleveland Clinic and Geisinger are few and far between. While there are dozens of start-up ACOs today, they are just that – start-ups. It’s also important to understand the kinds and types of subject matter experts that will be instrumental in these efforts. Experience with Patient-Centered Medical Home model is valuable as is expertise in training and disseminating new clinical models, implementing and optimizing health information technology and managing to Meaningful Use. Business acumen, expertise in governance models, understanding of reimbursement and revenue management, underwriting risk, Medicare policy and regulations, local market research and marketing…all of these skills are drawn upon. This is why we have taken an approach that features strategic and joint venture partners…no small team can manage all of these moving parts. It will take a tailored SWAT team approach in each unique instance.

I invite you to call on me if you have additional questions. I can be reached at 888-898-3280 ext. 802 or on my cell at 508-395-8429

Many thanks

Patrick Gauthier
Director

Comment on Behavioral Health Recommendations for Accountable Care Organizations by fran hathaway

fran hathaway — Fri, 02 Sep 2011 14:53:55 +0000

Hello,

I am a trustee of a foundation interested in furthering the integration of behavioral health in primary care and other specialties, especially in ACOs. First, how will CMS enforce the mandate you cite above? Second, are there any public or private matching grants for communities or groups that seek to encourage integration? And third, does your staff include consultants who have helped achieve this successfully by working with physicians, hosspitals and various behavioral health providers?

Thanks.

Comment on About Us by ASAP 13th Annual Conference: Behavioral Health in Transition | ASAP's Policy and News Blog

Thu, 25 Aug 2011 17:08:23 +0000

[...] CEO of the State Associations of Addiction Services (SAAS), and Patrick Gauthier, Director of AHP Healthcare Solutions. These and other plenary speakers will challenge attendees to think [...]

Comment on ASAM Redefines Addiction as a Chronic Brain Disorder – More Medicalization on the Horizon? by American Society of Addiction Medicine | LifeBlog

American Society of Addiction Medicine | LifeBlog — Wed, 17 Aug 2011 20:57:47 +0000

[...] explains why it is sometimes so difficult to quit on your own. The definition, published on the ASAM website, isn’t a necessarily a new direction as much as an effort to help bring more medical [...]

Comment on Magellan Launches Integrated Health Homes in Iowa by Harriet Markell

Harriet Markell — Wed, 27 Jul 2011 00:47:08 +0000

do we know exactly which services are provided in the cmhc? This is a great step in the right direction.

Comment on Carve-out versus Carve-in: Considering the Advantages and Disadvantages by Patrick Gauthier

Patrick Gauthier — Sat, 16 Jul 2011 22:26:50 +0000

My prediction is more of the same. The continued growth of well-managed BH benefits, integration with medical, growth in carve-out and growth in carve-in business. The market is vast. We will also see tons of consolidation. It’s going to be a wild ride for ten years before stabilizing. Then, we’ll see an explosion in Global Healthcare and people shopping for treatment worldwide. That began 5 years ago but it will really explode when reforms settle down. Imagine, Americans seeking BH treatment in India or Thailand. Happening already and only going to grow in popularity.

Lastly, as we move toward treating the whole person and understand that BH plays a critical role in chronic medical conditions, BH will be a big winner. We just need to get innovative, play like entrepreneurs, and get out of our own way!

Take care, Cindy

Comment on Carve-out versus Carve-in: Considering the Advantages and Disadvantages by Cindy Myers

Cindy Myers — Fri, 15 Jul 2011 23:20:27 +0000

Any psychic predictions, Patrick, about the future of outsourced BH services?