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<script> window.addEventListener('gpt-slots-ready', () => { googletag.cmd.push(function() { googletag.display('div-gpt-behavioralhealth_adunitb'); }); }); </script> </div> </div></div> <div class="grid-container"> <div class="grid-col single-content-column "> <header class="page-header archive-header"> <h1 class="page-title archive-title heading-with-border">Category: <span>Medicaid</span></h1> </header> <div class="posts-feed"> <article id="post-8543" class="entry-block entry-block-with-excerpt post-8543 post type-post status-publish format-standard hentry category-medicaid category-reimbursement tag-cityblock amn_content_type-news amn_word_count-350-700"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/reimbursement/" class="post-category post-category-tag"><span>Reimbursement</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/11/22/cityblock-health-validates-value-based-care-arrangement-with-11-5-payer-expense-reduction/">Cityblock Health Validates Value-Based Care Arrangement with 11.5% Payer Expense Reduction</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/mgonzales/">Morgan Gonzales</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-11-22T09:12:18-06:00">November 22, 2024</time><time class="updated" datetime="2024-11-22T09:12:21-06:00">November 22, 2024</time></span> </div> </div>  </header> <div class="entry-content"> <p>Traditional fee-for-service reimbursement arrangements may be leading to increased costs for payers. That’s according to new findings from value-based care provider Cityblock Health, published in NEJM Catalyst. The study found that Medicaid and dually eligible patients enrolled in Cityblock’s behavioral health program exhibited an 11.5% decrease in total cost of care and a 19.7% decrease […]</p> </div> </article> <article id="post-8501" class="entry-block entry-block-with-excerpt post-8501 post type-post status-publish format-standard has-post-thumbnail hentry category-bhb-plus category-commercial category-featured category-finance category-medicaid category-medicare category-original-story category-reimbursement tag-elevance-health tag-learn-behavioral tag-molina tag-ophelia tag-optum tag-the-cigna-group tag-unitedhealthcare amn_content_type-featured amn_word_count-over-1200"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/featured/" class="post-category post-category-tag"><span>Featured</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/11/14/medicaid-elevated-behavioral-health-utilization-had-payers-talking-in-q3/">Medicaid, Elevated Behavioral Health Utilization Had Payers Talking in Q3</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/mgonzales/">Morgan Gonzales</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-11-14T11:40:42-06:00">November 14, 2024</time><time class="updated" datetime="2024-11-14T11:40:45-06:00">November 14, 2024</time></span> </div> </div>  <div class="thumbnail-holder"> <a href="https://bhbusiness.com/2024/11/14/medicaid-elevated-behavioral-health-utilization-had-payers-talking-in-q3/"> <img width="150" height="115" src="data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%20150%20115'%3E%3C/svg%3E" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="A person's hands are interlaced on a table. In front of them is a laptop with financial graphs, a yellow mug, and a calculator." decoding="async" data-lazy-src="https://bhbusiness.com/wp-content/uploads/sites/7/2024/11/pexels-anna-nekrashevich-6801647-150x115.jpg" /><noscript><img width="150" height="115" src="https://bhbusiness.com/wp-content/uploads/sites/7/2024/11/pexels-anna-nekrashevich-6801647-150x115.jpg" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="A person's hands are interlaced on a table. In front of them is a laptop with financial graphs, a yellow mug, and a calculator." decoding="async" /></noscript> </a> </div>  </header> <div class="entry-content"> <p>The ongoing need for behavioral health services will be no surprise to anyone involved in the industry. Patients continue to have high rates of need and often present with greater acuity. This demand for behavioral health services was reflected across payers’ Q3 earnings calls. The result? Sky-high utilization levels. For example, David Cordani, the CEO […]</p> </div> </article> <article id="post-8495" class="entry-block entry-block-with-excerpt post-8495 post type-post status-publish format-standard has-post-thumbnail hentry category-addiction-treatment-business category-medicaid category-reimbursement"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/addiction-treatment-business/" class="post-category post-category-tag"><span>Addiction Treatment Business</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/11/12/cms-waivers-for-oud-alone-didnt-move-the-needle-on-overdoses-mat-utilization/">CMS Waivers for OUD Alone Didn’t Move the Needle on Overdoses, MAT Utilization</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/matthewblake/">Matthew Blake</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-11-12T15:58:27-06:00">November 12, 2024</time><time class="updated" datetime="2024-11-12T15:58:29-06:00">November 12, 2024</time></span> </div> </div>  <div class="thumbnail-holder"> <a href="https://bhbusiness.com/2024/11/12/cms-waivers-for-oud-alone-didnt-move-the-needle-on-overdoses-mat-utilization/"> <img width="150" height="115" src="data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%20150%20115'%3E%3C/svg%3E" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="Addiction Treatment Business logo illustrates Bradford Health Services M&A" decoding="async" data-lazy-src="https://bhbusiness.com/wp-content/uploads/sites/7/2023/10/2023-Addiction-WP-assets_featuredImg-posts-150x115.png" /><noscript><img width="150" height="115" src="https://bhbusiness.com/wp-content/uploads/sites/7/2023/10/2023-Addiction-WP-assets_featuredImg-posts-150x115.png" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="Addiction Treatment Business logo illustrates Bradford Health Services M&A" decoding="async" /></noscript> </a> </div>  </header> <div class="entry-content"> <p>In 2015, the Centers for Medicare and Medicaid Services (CMS) reversed a longstanding policy that barred the use of federal Medicaid money for patients residing in addiction treatment and mental health facilities with more than sixteen beds. The policy switch was intended to better help people in facilities with substance use disorder (SUD), particularly those […]</p> </div> </article> <article id="post-8469" class="entry-block entry-block-with-excerpt post-8469 post type-post status-publish format-standard hentry category-commercial category-medicaid category-medicare category-operations category-outpatient category-psychiatric-care category-reimbursement tag-lifestance-health amn_content_type-news amn_word_count-350-700"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/facility-type/outpatient/" class="post-category post-category-tag"><span>Outpatient</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/11/07/lifestance-surpasses-2024-forecasts-but-predicts-rockier-waters-ahead/">Lifestance Surpasses 2024 Forecasts But Predicts Rockier Waters Ahead </a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/mgonzales/">Morgan Gonzales</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-11-07T15:24:41-06:00">November 7, 2024</time><time class="updated" datetime="2024-11-07T15:24:44-06:00">November 7, 2024</time></span> </div> </div>  </header> <div class="entry-content"> <p>LifeStance Health (Nasdaq: LFST) is overhauling its facilities with a new operating model — one that it hopes will strengthen its position ahead of what executives expect to be a rocky 2025. The outpatient mental health giant’s executives project that federal reimbursement rate cuts will challenge the company’s financial progress. LifeStance is banking on momentum […]</p> </div> </article> <article id="post-8452" class="entry-block entry-block-with-excerpt post-8452 post type-post status-publish format-standard hentry category-commercial category-depression category-medicaid category-medicare category-original-story category-reimbursement tag-headway tag-the-national-quality-forum amn_content_type-news amn_word_count-701-1200"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/reimbursement/" class="post-category post-category-tag"><span>Reimbursement</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/11/05/major-insurance-companies-back-new-behavioral-health-measurement-standards-program/">Major Insurance Companies Back New Behavioral Health Measurement Standards Program</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/mgonzales/">Morgan Gonzales</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-11-05T07:00:00-06:00">November 5, 2024</time><time class="updated" datetime="2024-11-05T08:03:17-06:00">November 5, 2024</time></span> </div> </div>  </header> <div class="entry-content"> <p>The National Quality Forum (NQF) has partnered with a coalition of health plans and the national digital therapy enablement platform Headway to create a new assessment tool that standardizes how behavioral health clinicians measure the progress of care. The behavioral health industry, across specialties, has struggled with a lack of a standardized data measurement set. […]</p> </div> </article> <article id="post-8410" class="entry-block entry-block-with-excerpt post-8410 post type-post status-publish format-standard has-post-thumbnail hentry category-medicaid tag-kaiser-family-foundation amn_content_type-news amn_word_count-701-1200"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/reimbursement/medicaid/" class="post-category post-category-tag"><span>Medicaid</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/10/25/most-state-medicaid-programs-will-continue-to-make-behavioral-health-a-strategic-priority/">Most State Medicaid Programs Will Continue to Make Behavioral Health a Strategic Priority</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/clarson/">Chris Larson</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-10-25T15:08:30-05:00">October 25, 2024</time><time class="updated" datetime="2024-10-25T15:08:33-05:00">October 25, 2024</time></span> </div> </div>  <div class="thumbnail-holder"> <a href="https://bhbusiness.com/2024/10/25/most-state-medicaid-programs-will-continue-to-make-behavioral-health-a-strategic-priority/"> <img width="150" height="115" src="data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%20150%20115'%3E%3C/svg%3E" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="KFF state medicaid survey story illustrated by photo illustration of two women speaking" decoding="async" data-lazy-src="https://bhbusiness.com/wp-content/uploads/sites/7/2023/12/conversation-peers-mentors-therapists-150x115.jpg" /><noscript><img width="150" height="115" src="https://bhbusiness.com/wp-content/uploads/sites/7/2023/12/conversation-peers-mentors-therapists-150x115.jpg" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="KFF state medicaid survey story illustrated by photo illustration of two women speaking" decoding="async" /></noscript> </a> </div>  </header> <div class="entry-content"> <p>State Medicaid programs across the nation will continue to make behavioral health a strategic priority in 2025. A new survey report released by the Kaiser Family Foundation (KFF) found that half the state leaders of the joint federal-state health plan for the vulnerable want to expand the continuum of behavioral health services in their states, […]</p> </div> </article> <article id="post-8371" class="entry-block entry-block-with-excerpt post-8371 post type-post status-publish format-standard hentry category-bhb-plus category-compliance category-fraud category-medicaid category-medicare category-regulation tag-polsinelli amn_content_type-news amn_word_count-701-1200"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/regulation/compliance/" class="post-category post-category-tag"><span>Compliance</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/10/18/court-ruling-could-massively-curb-health-care-litigation-what-behavioral-health-operators-should-know/">Court Ruling Could Massively Curb Health Care Litigation: What Behavioral Health Operators Should Know</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/matthewblake/">Matthew Blake</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-10-18T09:31:52-05:00">October 18, 2024</time><time class="updated" datetime="2024-10-18T09:31:54-05:00">October 18, 2024</time></span> </div> </div>  </header> <div class="entry-content"> <p>A Florida federal court ruling issued last month could lead to a “massive sea change” in what lawsuits can be brought against behavioral health companies. That is the interpretation of Gregory Jones, a principal at the law firm Polsinelli’s Los Angeles office, who represents health care companies, including in False Claims Act (FCA) cases. FCA […]</p> </div> </article> <article id="post-8327" class="entry-block entry-block-with-excerpt post-8327 post type-post status-publish format-standard hentry category-fraud category-medicaid category-psychiatric-care category-regulation category-residential amn_content_type-news amn_word_count-350-700"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/facility-type/residential/" class="post-category post-category-tag"><span>Residential</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/10/10/senate-finance-chair-demands-doj-investigation-of-youth-treatment-centers/">Senate Finance Chair Demands DOJ Investigation of Youth Treatment Centers</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/mgonzales/">Morgan Gonzales</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-10-10T14:32:11-05:00">October 10, 2024</time><time class="updated" datetime="2024-10-10T14:32:14-05:00">October 10, 2024</time></span> </div> </div>  </header> <div class="entry-content"> <p>Youth behavioral health residential treatment facilities could face more scrutiny following additional public pressure by a powerful federal lawmaker. On Wednesday, Senate Finance Committee Chair Ron Wyden (D-Oregon) publicly called on the U.S. Department of Justice (DOJ) to investigate four major behavioral health providers to determine if their youth residential treatment programs committed Medicaid fraud. […]</p> </div> </article> <article id="post-8298" class="entry-block entry-block-with-excerpt post-8298 post type-post status-publish format-standard has-post-thumbnail hentry category-addiction-treatment-business category-digital-health category-inside-the-c-suite category-medicaid category-substance-abuse tag-ophelia amn_content_type-news amn_word_count-701-1200"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/addiction-treatment-business/" class="post-category post-category-tag"><span>Addiction Treatment Business</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/10/02/ophelias-playbook-how-to-scale-medicaid-oud-treatment/">Ophelia’s Playbook: How to Scale Medicaid OUD Treatment</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/mgonzales/">Morgan Gonzales</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-10-02T13:55:54-05:00">October 2, 2024</time><time class="updated" datetime="2024-10-02T14:24:06-05:00">October 2, 2024</time></span> </div> </div>  <div class="thumbnail-holder"> <a href="https://bhbusiness.com/2024/10/02/ophelias-playbook-how-to-scale-medicaid-oud-treatment/"> <img width="150" height="115" src="data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%20150%20115'%3E%3C/svg%3E" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="Addiction Treatment Business logo illustrates Bradford Health Services M&A" decoding="async" data-lazy-src="https://bhbusiness.com/wp-content/uploads/sites/7/2023/10/2023-Addiction-WP-assets_featuredImg-posts-150x115.png" /><noscript><img width="150" height="115" src="https://bhbusiness.com/wp-content/uploads/sites/7/2023/10/2023-Addiction-WP-assets_featuredImg-posts-150x115.png" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="Addiction Treatment Business logo illustrates Bradford Health Services M&A" decoding="async" /></noscript> </a> </div>  </header> <div class="entry-content"> <p>Opioid use disorder (OUD) disproportionately impacts Medicaid beneficiaries, yet structural barriers – including lack of available clinicians – often keep this population from receiving treatment. Virtual OUD treatment provider Ophelia has expanded its Medicaid reach by inking new reimbursement contracts that cover the lives of 3 million New Jersey residents. “We’ve been live and treating […]</p> </div> </article> <article id="post-8286" class="entry-block entry-block-with-excerpt post-8286 post type-post status-publish format-standard has-post-thumbnail hentry category-autism-business-news category-autism-idd category-medicaid category-technology tag-cognoa amn_content_type-news amn_word_count-350-700"> <header class="entry-header"> <div class="entry-header-content"> <div class="category-tag-holder"> <a href="https://bhbusiness.com/category/autism-business-news/" class="post-category post-category-tag"><span>Autism Business News</span></a> </div>  <h2 class="entry-title"><a href="https://bhbusiness.com/2024/09/30/setting-a-precedent-cognoa-earns-medicaid-coverage-for-early-autism-diagnosis-tool/">‘Setting a Precedent’: Cognoa Earns Medicaid Coverage for Early-Autism Diagnosis Tool</a></h2> <div class="entry-meta"> <span class="byline"> By <span class="author vcard"><a class="url fn n" href="https://bhbusiness.com/author/rholly/">Robert Holly</a></span></span> | <span class="posted-on"><time class="entry-date published" datetime="2024-09-30T10:36:44-05:00">September 30, 2024</time><time class="updated" datetime="2024-09-30T14:02:46-05:00">September 30, 2024</time></span> </div> </div>  <div class="thumbnail-holder"> <a href="https://bhbusiness.com/2024/09/30/setting-a-precedent-cognoa-earns-medicaid-coverage-for-early-autism-diagnosis-tool/"> <img width="150" height="115" src="data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%20150%20115'%3E%3C/svg%3E" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="Autism Business News logo for story about Axis Therapy Centers" decoding="async" data-lazy-src="https://bhbusiness.com/wp-content/uploads/sites/7/2024/02/2023-ABN-WP-header-featured-img-alt-img_featuredImg-posts-150x115.png" /><noscript><img width="150" height="115" src="https://bhbusiness.com/wp-content/uploads/sites/7/2024/02/2023-ABN-WP-header-featured-img-alt-img_featuredImg-posts-150x115.png" class="attachment-agingmedia-thumb-medium size-agingmedia-thumb-medium wp-post-image" alt="Autism Business News logo for story about Axis Therapy Centers" decoding="async" /></noscript> </a> </div>  </header> <div class="entry-content"> <p>More innovative solutions around autism diagnostics are starting to gain momentum. The latest example of this idea: Wyoming’s Medicaid program will cover Cognoa’s Canvas Dx product. According to a Sept. 26 announcement, Wyoming is now the first state to cover Cognoa’s tool for early-autism diagnosis. Dr. Sharief Taraman, CEO of Cognoa, described the move as […]</p> </div> </article> <div class="pagination"> <span aria-current="page" class="page-numbers current">1</span> <a class="page-numbers" href="https://bhbusiness.com/category/reimbursement/medicaid/page/2/">2</a> <a class="page-numbers" href="https://bhbusiness.com/category/reimbursement/medicaid/page/3/">3</a> <span class="page-numbers dots">…</span> <a class="page-numbers" href="https://bhbusiness.com/category/reimbursement/medicaid/page/19/">19</a> <a class="next page-numbers" href="https://bhbusiness.com/category/reimbursement/medicaid/page/2/"><span>Next</span></a> </div>  </div>  </div>  <div class="grid-col grid-col-1-of-3"> <div class="primary-sidebar-holder widget-area desktop-only" role="complementary"> <section id="custom_html-2" class="widget_text widget widget_custom_html"><div class="textwidget custom-html-widget"><div style="width:300px;height:600px;">  <div id='div-gpt-behavioralhealth_adunitc'> <script> 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