Executive Briefing | by Richard Louis, III | October 10, 2017
More mental health services are being delivered in primary care settings and by organizations with a primary care focus (see Pay-For-Value & Mental Health Treatment – Reading The Tea Leaves and The On-The-Ground Reality Of Integrated Care Coordination). So what strategies should executives at mental health provider organizations maintain for their consumer base and the revenue associated with those consumers?
That was the focus of my session at the 2017 OPEN MINDS Executive Leadership Retreat, Diversifying Your Revenue Streams: How To Successfully Launch A New Service Line, featuring Kristi Daugherty, Chief Executive Officer at Emergence Health Network in El Paso, Texas. I see opportunity in this situation, largely because primary care physicians are not equipped to treat behavioral health disorders (see National Association of State Mental Health Program Directors, Fact Sheet, June 2012 and What’s With The 4.2%?). But to serve consumers in more “integrated” settings means making changes in your market positioning and your service delivery models.
During the session, Ms. Daugherty talked about the changes her organization, Emergence Health, made to position themselves in this market. Emergence Health Network, which is a community mental health center serving as the Mental Health/Intellectual Disabilities Authority for El Paso County, adjusted to market forces by identifying new service line opportunities; and adopting a new integrated primary care/mental health services model to leverage new sources of funding and to expand EHN’s treatment population profile. (For more on EHN, see Success Through Leveraging The Skills Of Your Team – Leadership Advice From Emergence Health Network’s Kristi Daugherty.)
Ms. Daugherty explained that EHN repositioned by purchasing psychiatric physician practices; assumed the operations of a behavioral health clinic specializing in partial hospitalization and intensive outpatient programs and programming for USPO offenders; and expanded services to include primary care.
Emergence took a few different tactics to expand their services offerings – each with varying levels of success. One program expansion that created some challenges was the purchase of a psychiatry practice. Purchasing the practice enabled Emergence to diversify its payer mix by working with private pay consumers and those with commercial insurance. However, the purchase of the entire practice didn’t necessarily result in all the expected benefits – on the payer side, there was additional work to re-contract with all the psychiatrist’s existing payers, and on the consumer side, the psychiatrist’s existing caseload was not necessarily as active as anticipated.
On the integration side, they expanded their primary care services by hiring a full-time primary care physician, who was co-located with their psychiatric practice. In addition, they created a partnership with the county hospital clinics to place one of their staff members, a masters level qualified mental health professional, on-site at the clinic. This behavioral health support professional is on hand to help coordinate care and connect consumers with psychiatrists or other mental health professionals.
Why take note of this shift? In today’s market, it is a big risk to “put all your eggs in one basket” by relying on only one or two sources of funding. Community mental health provider organizations need to be positioned to offer the mental health services traditionally offered to public payers, but also ready to provide services to a variety of private sector payers in both outpatient primary care and acute care medical settings. Some of these services may have new names, but it is likely that your organization has the competencies you need to be successful—high-touch coordinated care (formally targeted case management); linkage to social determinants (formally referral to community supportive services); and proactive outpatient or in-home patient engagement (formally early intervention and prevention). These services are increasingly seen in integrated or co-located behavioral health service venues.
For more from diversifying your revenue streams, check out these resources from the OPEN MINDS Industry Library:
For more, including new models for care management that promote integrated care coordination, join OPEN MINDS Chief Executive Officer Monica E. Oss, on November 7 at The 2017 OPEN MINDS Technology & Informatics Institute when she leads the town hall discussion, “Future State: Evolving Care Models For Improving Population Health”, featuring Scott Green, Sr. Vice President, CareGuidance, Netsmart; and Rachelle Glavin, Director of Clinical Operations, Missouri Coalition for Community Behavioral Health.