We routinely hear about substance abuse treatment programs that are struggling, and while there is an ongoing difficulty with getting insurance companies to adequately pay for treatment currently, let’s not forget how we got here.
Tighter restrictions from payers – Yes, today there are major insurance companies doing shady things. From outright denying claims for no reason and sending payments to clients instead of providers, to reducing the number of covered days, lowering the allowed amounts and trying to force everyone to meet their fee schedules. On the flip side of this, there are more than enough examples of treatment providers bilking the system for too many drug tests and lab kickback schemes, billing for services not delivered or at inappropriate levels of care, and even intentionally having people relapse to test positive and readmit starting back at detox all over again.
Obviously not everyone tried to cheat the system, and in reality it was only a fraction of the programs, but it was enough to catch the attention of the companies and regulatory agencies.
Forcing LegitScript for paid ads online – When Google limited AdWords access for treatment centers in September of 2017, it instantly crippled many good programs who were dependent on that form of advertising for their services. Then, they eventually brought it back, but forced each one to go through a private company for a form of verification and vetting process. Although initially sounding good on the surface, it has been far from perfect, and to expensive of a mandate for some small facilities to have to compete with. Unfortunately, Facebook and Bing later followed suit.
We feel that the original good intention of wanting to clean up the ad space was an honorable attempt, but it is of course far from perfect. Maybe other similar vetting companies can be approved as well and do it for less money so that it can even the playing field for all programs, not just allow those with more money and resources control more of the space. Again, if there hadn’t been bad actors out there being deceptive with their marketing tactics, such action would not have been taken.
There are definitely other influences that have caused the current difficulties for many facilities out there today. We feel that the pendulum will eventually swing back the other direction and things will find a happier medium on many of these topics. The fact is that the overwhelming majority of treatment centers are doing wonderful things to help people recover, and that should remain the focus of the industry.
In the meantime, treatment providers must learn how to adapt in order to make their services known and available to people so that they can keep their census high enough pay the bills. For some, this may mean getting some admissions training, some consulting, or changing their marketing approach all together. For others, it may mean adding or removing services they provide, going in-network with some carriers, or adding levels of care to their continuum.
If you have a treatment program that is struggling in today’s industry climate, contact us to see if we can help.