BHM Explores "Pay for Prevention" in Their Online Newsletter
BHM Industry News, an online and printable newsletter released by BHM Healthcare Solutions, a behavioral health consulting firm explores this issue in further detail. “We are always interested in keeping up with the latest trends in behavioral healthcare that could prove advantageous to our clients,” stated Danyell Jones, Director of Customer Solutions at BHM “this is why we thought that doing a piece on pay for prevention could really open people’s eyes to an idea that they may not have tried before to have a positive financial impact on their organization.”
“Pay for Prevention” has been an idea which has circulating for some time, but is gaining increasing momentum as healthcare professionals continue to explore ways to decrease healthcare costs for the general population. The basis behind “Pay for Prevention”, and idea which offers monetary incentives for healthy behavioral choices made by an individual targets some of the most chronic and costly diseases that face the general population, but that are for the most part preventable by making healthy behavior choices. Some of these preventable and costly diseases include cardiovascular disease, diabetes, obesity, and cancer. Healthy behavioral choices such as increasing exercise, improving dietary choices, and abstaining from smoking have been shown to prevent or reduce the effects of these diseases.
In a recent article appearing in the New York Times it was stated that “studies show that 50 percent to 70 percent of the nation’s health care costs are preventable.” Spurred on by this information some major employers such as Safeway and GE have begun to offer cash incentives for employees who choose a healthier lifestyle. Additional incentives are being offered by some of the nation’s major insurers. In exchange these insurers offer lower premiums for healthy choices, and business based cash incentive plans that pay employees money for meeting fitness goals, or abstaining from smoking.
Findings have consistently shown that offering rewards for good behavior has been vastly more effective than punishments for bad behavior. According to Gary Charness, economist at the University of California, “financial incentives can kick start healthy habits that can then become self sustaining.”
For the full article, and even more industry news please visit BHM's Online Newsletter page.
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BHM Appoints New Senior Vice President of Finance and Claims Operations
BHM is excited to announce the appointment of Brian Johnson to the position of Senior Vice President of Finance and Claims Operations. Mr. Johnson brings a wealth of managed care and financial knowledge to the organization, as well as a solid reputation for innovative financial solutions for the fast paced health care industry.
Mr. Johnson will be heading up the BHM team of financial consultants as Senior Vice President of Finance and Claims Operations. Mr. Johnson who is known for his exemplary knowledge of financial analysis, budgeting, claims, authorization, credentialing, and pharmacy workflows and processes will bring a wealth of expertise to BHM.
In this role Mr. Johnson will be responsible for all Financial Analysis and Claims Operations work within BHM. Prior to joining BHM Mr. Johnson was the director of Finance at APS Healthcare, Inc., and the Director of Financial Planning and Analysis at APS Healthcare, Inc. Mr. Johnson has over 14 years of experience in healthcare finance with 11 years of management experience. BHM is very excited to have Mr. Johnson join the organization, and looks forward to the benefit its customers will receive from his vast knowledge in the field. “Brian is an extremely talented finance professional.
Through his efforts the basis for the planning, budgeting, and financial reporting system was created at APS healthcare. He has a rare ability to combine data analysis and data reporting skills. I could always depend on Brian to produce actionable information from our many disparate systems. Brian is also an effective manager and leader. His management style would be a benefit to small and large organizations alike,” stated Steve DaRe, CFO of APS Healthcare.
Upon his appointment to his new position Mr. Johnson stated that “I look forward to working within BHM Healthcare Solutions, and with their clients. I will continue to strive to bring effective and innovative financial solutions to our clients in order to increase the profitability of their organizations.”
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BHM Announces the Addition of Vice President of Clinical Operations
BHM Healthcare Solutions is pleased to announce the addition of Fred Richmond, MBA, PhD to its team of expert healthcare consultants. Dr. Richmond is a highly qualified healthcare consultant and will serve in the capacity of VP of Clinical Operations at BHM.
Dr. Richmond has had a long and distinguished career in the healthcare and behavioral health fields. He recently served as the executive director for the American Academy of Pediatrics in California. Prior to this Dr. Richmond dedicated himself to the impressive position of Chief Executive Officer for the Coalition of Orange County Community Clinics. During his time at the Coalition of Orange County Community Clinics Dr. Richmond provided outstanding administrative leadership, infrastructure, and overall management direction for 17 Community Health Organizations with 46 separate facilities. Other positions Dr. Richmond has held include Director of the University of Massachusetts Medical School, Chief Operating officer for Progressions Group-Eugenia Hospital in Lafayette Hills, PA, and Clinical Director for Universal Health Services in Chester Pennsylvania, and Northwestern Institute Child and Adolescent Services.
Dr. Richmond also has extensive experience serving as a senior consultant for a number of organizations including the Public Consulting Group, where he led recovery efforts to recoup lost revenue and was responsible for $4 million dollars in additional sales projects, Pricewaterhouse Coopers, LLP where led recovery efforts and provided ongoing education and training for both physicians and clinicians.
“It is rare to find someone with such a distinguished set of qualifications, who also exemplifies what a leader in the behavioral healthcare field should be,” stated Mark Rosenberg, President of BHM. Dr. Rosenberg went on to state that “we look forward to working with Dr. Richmond, and fully believe that his unique abilities to mentor, empower, cross-train and engage will be uniquely beneficial to all of our current and future BHM clients.”
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BHM Speakers Meet with Success at NAMCP Fall 2009 Managed Care Forum
The National Association of Managed Care Providers Fall Managed Care Forum held Nov. 12th and 13th, 2009 was the must attend event for healthcare professionals this fall season. From the elegant location at the Bellagio Hotel in Las Vegas to the enticing line up of dynamic speakers the forum was filled with opportunities for healthcare professions to remain on the cutting edge of healthcare industry news and education.
The forum which focused thought provoking topics, and expert insight provided attendees with opportunities to directly affect the success of their organizations. “Keynote, concurrent, and workshop sessions as well as networking events and an exhibit hall filled with product and service solutions provided the best networking opportunities and presented innovative solutions to today’s healthcare challenges” stated one of the Forums representatives.
Among the panel of experts at the forum were 4 representatives of BHM who gave a variety of talks, all of which proved to be well attended. Dr. Rosenberg, President and CEO of BHM Healthcare Solutions delivered an insightful and informative talk about ADHD and recent advances in the treatment of the disease. This talk which focused on Hyperactivity and Impulsivity gave new insight into diagnosis, management and treatment of this common disease from both the adolescent and adult treatment perspectives. Dr. Rafeyan, a notable physician gave a talk focusing on Depression. Specifically addressed were the financial and fiscal impacts of the disease from a patient, societal, and payer perspective. Cost effective disease management of Bipolar disorder was the subject of a talk given by Dr. Faber who not only provided participants with a thorough overview of the disease, but focused on how effective disease management could benefit healthcare organizations and improve their bottom lines. Finally Dr. Sicuro, also representing BHM gave provided a presentation for providers focused on Alzheimer’s disease. Early diagnosis and effective treatment were topics which were explored providing listeners with a variety of information covering everything from latest treatment options, to more effective and responsive diagnosis within various healthcare environments.
With near capacity attendance and audience feedback ratings of 3.6-3.8 (on a scale of 1-4) BHM executives consider the forum a success for both those who attended and those who gave presentations. “It is our goal as an organization to continue to provide and present relative, informative, and groundbreaking information to medical professionals and healthcare insiders,” stated Mark Rosenberg, CEO of Behavioral health who went on to state “we look forward to the upcoming spring forum and the opportunities it will provide for all members of the healthcare field to stay up to date with the latest information, and the inspiring ways which it can be used to have a positive impact within their organizations.”
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BHM Presentations at US Psychiatric Congress Picked Up by National Publications
Among the recent presenters at the US Psychiatric and Mental Health Congress of 2009 which was held on Nov. 2nd-5th at Mandalay Bay in Las Vegas, NV was BHMs own President and CEO Mark Rosenberg. Two presentations were delivered on practice management which concentrated on reducing denials and improving profitability, hot topics in recent healthcare news.
The first talk entitled Understanding Managed Care: Reducing Denials provided listeners with a detailed understanding of the authorization and denial process that Managed Care Use. In addition to this attendees learned the rules that Managed Care Companies should be following and gained valuable insight into the entire appeals process, and how impactful good follow up can be for an organization. Following this Dr. Rosenberg provided listeners with the CORE principles that BHM expert advisors implement to reduce denials within healthcare organizations. “Health care claims which are rejected or denied lead to millions of dollars of lost revenue each year” stated one BHM insider. This is one reason why understanding denials and how to prevent them can be so pivotal to the success of an organization.
The second talk which Dr. Rosenberg presented at the congress was entitled Understanding Managed Care: Increasing Profitability. Any healthcare or managed care professional could find benefit for their organization within the talk’s main points which covered data tracking, benchmarking, and improving practice outcomes. In addition to these topics the billing cycle was addressed in depth with the focus on how an organization could immediately utilize key strategies to improve the amount and the rate at which revenue is collected.
From coding to collections, denials to data tracking all key ingredients to improving the success and profitability were covered. Following the presentation Dr. Rosenberg was available to attendees to address specific concerns that they may have had within their own organizations. Besides proving a valuable resource for those who attended the advice of BHM continued its impact when a portion of Rosenberg’s presentation was picked up by the The Psychiatric Times. The Nov. 18th, 2009 edition of The Psychiatric Times concentrates on the four most effective steps an organization can implement in order to decrease their no show appointments. A full summary of these points can be found in the Dec. 2009 BHM Newsletter.
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BHM Mental Health Parity Whitepaper Picked Up by Healthcare Websites
 The BHM Whitepaper entitled Mental Health Parity Preparedness was recently picked up by two notable healthcare websites. The white paper which gives a great overview of the Paul Wellstone Mental Health and Addiction Equity Act from the perspective of proponents and opponents also focuses on what Managed Care Companies can do to prepare for the coming changes.
The BHM white paper was picked up in December. 2009 by Wellsphere, a leading healthcare reference website whose mission is “to help millions of people live healthier, happier lives by connecting them with the knowledge, people, and tools they need to manage and improve their health.” Beyond providing medical information for its viewers Wellspere helps to connect healthcare industry insiders. The site boasts of many interactive features including numerous search engines, access to prominent healthcare writers, and an index of health related blogs.
Additionally in December Mental Health Parity Preparedness was featured in a on a Healthcare Management Consulting index site, and was the focus of a Google Healthcare Web Elements banner. This site which gives access and serves as a directory for healthcare management firms featured a descriptive paragraph and interactive link the BHM whitepaper.
“When writing the white paper we wanted to let organizations know that there was something that they could do to prepare their organization for the upcoming parity changes. It was also our goal to give general insight into the topic from numerous perspectives in a format that was relevant to a wide reader base” Stated Danyell Jones, a BHM representative. Jones further went on to state that “we are very excited that our paper is being picked up and proving to be a useful resource for a variety of people in the healthcare profession.”
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BHM Helps Provider Organization Recoup $800,000 in First 3 Months
 BHM was recently approached to work with an organization that was experiencing a number of collection related problems. These problems were leading to organization wide issues as they contributed to a significant cash flow problem.
“Upon our first look at the organization we estimated that there were millions of dollars in current uncollected revenue:” said Mr. Johnson, financial expert analyst for BHM. The first step of working with this organization was to conduct a detailed analysis of multiple departments to identify areas for improvement.
After working to help the organization develop and correct tracking methods BHM analysts made specific recommendations based on their findings. The analysts identified multiple areas for improvement and proposed a detailed review to complete the contact to payment revenue cycle. This healthcare financial analysis was specifically designed by the analysts to analyze systems and procedures that collect information in the key areas of: first contact, scheduling, documentation, billing, and payment.
Within the first three months of working with BHM consultants, this organization recouped a total of $800,000.00 in lost revenue. These resulting improvements of the organization had the added benefit of helping them to reduce cash flow problems which they were previously experiencing.
The new processes and procedures being put into place by BHM continue to ensure that billing and coding are optimized and that collections are current and correct. The organization continues to experience a dramatic increase in revenue due to the implemented changes.
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