Where Management and clinical goals meet
Too often quality or ambitious clinical programs do not get the resources they need to successfully help clients in their journey in recovery.
Most of the time, this unfortunately stems from inadequately set priorities.
Traditionally, financial constraints will dictate how programs are run.
It should not be that way.
What matters first is the vision.
In the healthcare field, entrepreneurs’ vision should take into account economic realities and imagine responses to these challenges.
For instance, healthcare insurance payments to providers have become less generous and clients’ financial burden has steadily increased over the years.
How can SUD providers better deal with this challenge?
First, providers can develop relationships with medical lenders who can help clients in need.
Second, providers can closely and constantly audit paid claims for short payments and \ or unbilled services.
Third, providers can closely work with one or more non-profit organizations to raise additional funds to cover shortfalls sourced in healthcare insurance pay out plans.
Fourth, providers can create additional sources of income. They are the perfect fit to provide valuable, low-cost, community-oriented family counseling and prevention programs (that focus on life improvement rather than addiction).
Fifth, providers may create pool exchanges.
Sixth, providers may seek financial sponsorship from vendors and community pillars.
Seventh, providers may hire professional fundraisers – grant writers.
For each of the seven leads, Management must take the lead and prioritize its actions.
The low hanging fruits (no to low cost and quick implementation) are:
- In the example above, establishing a business relationship with one or more medical lenders is a process that should not take more than 40 hours and one month to fully implement.
- Auditing billing can be achieved internally or externally when billing is handled by a third party. In the latter case, this specific aspect of billing should be clearly defined between the parties and respective expectations defined as well. Setting up internal procedures and expectations with billing companies should not take more than 40 hours and one month to fully implement.
- Sponsorship from providers and community pillars. Roughly, vendors’ costs represent between 10 % and 20 % of treatment centers’ P&L respectively for outpatient and inpatient facilities. Depending on the size of business a sponsorship of 2.00% can go a long way. Community pillars can be substantial contributors as well. They can be community banks, major retailers, or major businesses. Such programs shall yield results within 90 days and may require 120 hours to fully implement.
Programs requiring focus, time, and some resources are:
- The hiring of grant writers and \ or fundraisers will require an extended vetting process and some seed money. Implementing these solutions can take up to 6 months, and yield results within 12 months.
- Reaching out to non-profit organizations can take up to 6 months, and yield results within 12 months.
- Creating your own non-profit organization requires time and resources.
- Creating community-oriented family counseling and prevention programs will easily take 6 to 12 months, requiring 240 hours of work before implementation. Community outreach is a constant effort that is to be added to the program design and execution.
These examples show that clinical goals can be met in an economically challenging environment when Management creates additional resources to support traditional business models.
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