Outcome Surveys: An Additional Revenue Source For Billing Companies

After the ACA mandated insurance companies to cover addiction treatment and mental health, healthcare insurance and governmental sponsored programs adapted. They implemented operating standards that have affected major healthcare providers and research centers as well.

This operational shift began in 2017, and it is key to achieving greater accountability and cost control among the ever-increasing healthcare costs in the United States.

Unfortunately, due to economic constraints that impact many SUD providers, the implementation of outcome surveys – that are in fact measuring provided care efficacy – has fallen behind schedule.

This delay will be extremely damaging for unprepared Providers when they are confronted with healthcare insurance adding a performance component in their claim payment matrix. Since billing companies’ revenues are linked to Providers’, a drop in Providers’ revenues will create a drop in billing companies’ revenues as well.

When the SUD treatment industry was emerging, a comparable situation occurred in the billing industry. Overtime, Providers had to hire billing companies because these companies were better equipped, better staffed, better informed, and constituted a variable cost rather than an “in house” service which is a fixed cost.

All along, billing companies have been instrumental in making regulatory and healthcare insurance demands manageable for Providers.

Again, with the pressing need for quality outcome surveys, billing companies can help their clients by better coordinating outcome surveys with their core services.

This added benefit for SUD providers can quickly become an additional source of revenue for billing companies.

So, how can billing companies help SUD providers implement quality outcome surveys while simultaneously developing an additional source of revenue?

Two basic options come to mind.

- Option 1: They can develop their own computer program, related policies and procedures, implement, and market them.

This solution is costly, as such software will require – among other things – (i) in depth analysis, (ii) architecture development, (iii) coding, (iv) testing, (v) tuning, (vi) operator training, and (vii) troubleshooting. To make things harder, software development costs can be recouped over time with their own client portfolio only, increasing the additional service offered substantially.

This solution is also time consuming. It is reasonable to expect a minimum of 12 months to develop the core elements of an outcome survey program, and an additional 12 months to vet the system (beta), bringing the time to market to two years.

Based on our own experience, this process can be easily cost $ 1 MM.

- Option 2: Make an alliance with a “partner” who has the sought-after expertise. This option presents three related programs, (i) referral program, (ii) agency program, and (iii) licensing program.

A referral program is the fastest and easiest way to provide clients with a solution to their challenge. It also generates supplemental revenue without any investment.

An agency program where the billing company teams with an outcome survey provider on a scale that is territory based and accordingly greater than its own client portfolio. This type of arrangement can be quickly implemented as well. It requires, however, greater commitment from the billing company.

A licensing program where the billing company is a master licensee who can either operate the system themself (and bill Providers like an outcome survey provider does) or license Providers (who can run the program themselves) in each territory. This program is cost effective and contributes to both licensors’ and master licensee’s benefit.

At Seed4Success, we have carefully reviewed and crafted programs matching the three options briefly described above. For more information, contact us at info@seed4success.com