TUCSON, Ariz., Dec. 9, 2016 /PRNewswire-USNewswire/ -- Going forward into the Trump presidency, one thing is certain: US healthcare insurance will change. HHS Secretary nominee Tom Price is a vehement ObamaCare critic. When he takes the reins, we can expect a revamp of both the Affordable Care Act (ACA) and Medicaid.
The most likely change will be an attempt to control costs by restructuring Medicaid from a federally-run program into a set of block grants at the state level. If history is any guide, this will result in reduced reimbursement for treatment services, which is very bad news for Addiction Rx providers and the communities they serve.
Given the seriousness of the situation, VERTESS recommends that Addiction Rx providers take immediate steps to 1) apply political pressure to prevent a move to block grants and 2) position their company to adapt quickly if and when that change takes place.
To apply political pressure, contact your U.S. senators and member of Congress and emphasize that the rampant growth of addiction in your state is a crisis situation to which the proper response is an increase in funding, rather than seeking cost savings.
You might also ask your clients to do the same, since they're the people whose health will be at risk if the new administration implements block grants.
At the same time, take immediate action to position your company to successfully pivot and adapt to any changes that might be coming. Specifically, we recommend the following:
- Research your marketplace: Successful action will require an honest, and possibly brutal, assessment of what options are available to you and what you may need to do to continue to thrive if the government implements a capped reimbursement model (such as block grants).
- Create a response plan: Be ready to implement and respond to multiple reimbursement and contracting scenarios, whether in-network or out-of-network, with accompanying projections and associated revenue requirements.
- Develop best practices: Whatever happens, you want to be the most competitive company in your region. For example, you may want to pursue additional external accreditation that can be advantageous in a managed care environment.
- Prepare your technology: You will need reliable and flexible data capabilities that allow you to measure and tune your entire operation, from internal operational outcomes to external funding requirements. Do not put this on the back burner.
- Expand your network: To protect your company and position it effectively, identify and cultivate potential affiliations and partnerships.
Above all, you cannot afford to "hunker down and hope for the best" as a response to TrumpCare. Instead, you must take action NOW to ensure that you're ready for the changes to come.
If you would like to schedule an interview or learn more, please contact Tom Schramski directly at email@example.com or 520.975.5347.
VERTESS is a healthcare-focused M+A firm with expertise in diverse healthcare and human service verticals, ranging from behavioral healthcare, substance abuse treatment and cognitive disabilities to DME, home care/hospice, urgent care centers and other specialized services and products. The VERTESS professional M+A team members have a combined 100+ years of executive experience launching, building and successfully exiting their own healthcare companies, giving them a unique understanding of the objectives of healthcare owners and executives. For more information, visit www.vertess.com.
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