Video: What the GOP's $1 trillion Medicaid cuts could mean for healthcare
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Time Business News
31 minutes ago
- Time Business News
Navigating the IOP Landscape: A Step-by-Step Startup Guide
Launching an Intensive Outpatient Program in behavioral health is an opportunity to combine strong clinical impact with a scalable business model. It begins with understanding your community's needs, defining your target population, and shaping a program that fills an actual gap in care. This requires market research, competitor analysis, and conversations with referral sources to design group schedules, specialty tracks, and service hours that truly fit the lives of those you aim to serve. Creating an intensive outpatient program begins with identifying the specific needs of your target population and developing a service model that delivers measurable results. Careful planning ensures the program offers flexible scheduling while maintaining clinical rigor. Securing qualified staff, establishing evidence-based treatment protocols, and complying with local and federal regulations are vital steps. Knowing how to start an IOP program means also addressing insurance credentialing, community outreach, and outcome tracking to demonstrate value. When designed thoughtfully, such programs provide the structure and support clients need to recover while continuing their daily responsibilities, fostering long-term healing and stability. Once your concept is clear, choosing a compliant, accessible location is essential. Your site should be zoned appropriately for healthcare, designed to ensure privacy, and equipped with multiple group spaces, a private intake area, and technology-ready rooms for telehealth. From the start, align your licensing and accreditation plan with state requirements—such as DHCS Licensing for Behavioral Health in California—and aim for CARF or Joint Commission accreditation to strengthen both credibility and payer relationships. Your clinical program should follow evidence-based practices and offer a structured mix of group therapy, individual sessions, family involvement, and psychiatric care. Clearly define admission criteria, safety protocols, and step-up or step-down care pathways. A strong staffing plan is crucial, with leadership, licensed clinicians, case managers, and prescribers all in place, and payer credentialing for each provider completed early to avoid delays. Supporting this team with an EHR designed for behavioral health, HIPAA-compliant telehealth tools, and robust documentation workflows will set the tone for smooth operations. Financial planning is equally important, with a realistic budget that covers startup expenses, operating reserves, and the inevitable collections lag in insurance-based care. Develop a payer mix strategy that blends commercial insurance, Medicaid where viable, and cash pay options, while maintaining rigorous denial management practices. Ethical marketing—built on strong referral networks, local SEO, and a responsive intake process—will help admissions grow steadily without overreliance on advertising. From referral to discharge, every step in the client journey should be mapped and intentional. Intake processes, treatment planning, progress tracking, and alumni engagement must be consistent and streamlined. Measurement-based care using tools like the PHQ-9 or GAD-7 not only improves clinical quality but also supports payer negotiations and continuous quality improvement. Alongside this, strict adherence to HIPAA, 42 CFR Part 2, and risk management protocols ensures client trust and protects your business from compliance issues. Establishing a behavioral health program begins with a clear framework for quality, safety, and accountability. From securing the right facility to hiring qualified staff, every step must align with industry regulations. A crucial part of this process is understanding and obtaining DHCS licensing for behavioral health, which ensures that your services meet state standards for treatment delivery and patient protection. This involves preparing documentation, passing inspections, and adhering to ongoing reporting requirements. Compliance not only protects your organization legally but also strengthens trust with clients and payers, setting the stage for long-term sustainability in the behavioral health field. Launching an IOP successfully means starting small, testing workflows, collecting feedback, and refining before scaling. Once operations are stable, you can expand to additional tracks, services, or locations, supported by standardized policies, clinical curricula, and data-driven decision-making. For those exploring how to start an addiction treatment center through a broader network, a well-run IOP can become both a powerful standalone business and a strategic building block for future growth. TIME BUSINESS NEWS
Indianapolis Star
7 hours ago
- Indianapolis Star
Indiana families are fighting a FSSA change. A federal appeals court just ruled in their favor
A federal appeals court has ruled in favor of two medically fragile children from Indiana and their families who are fighting changes made by the state Family and Social Services Administration to a Medicaid waiver program. Indiana Disability Rights and the ACLU of Indiana filed a lawsuit last May alleging that the state's changes to its Health and Wellness Medicaid Waiver program, which impacted parents who were providing paid care to medically complex children, went against the Americans with Disabilities Act. The U.S. Seventh Circuit Court of Appeals on Aug. 11 affirmed a district court's prior preliminary injunction in favor of the families who sued. "As the district court concluded, plaintiffs have a high likelihood of succeeding on the merits of their ADA claims," according to the 50-page opinion. "Further, we find no abuse of discretion in the district court's balancing of the equities or its assessment that the public interest is best served by preserving plaintiffs' access to medically necessary care and enforcing federal antidiscrimination law." The decision doesn't apply to the whole state. It means that, for now, the two families can continue to serve as paid providers of "attendant care" for their children, according to a press release from the ACLU. Indiana Disability Rights said in a statement that the court's decision recognized the likelihood that parents would have to make an "unthinkable" decision of placing their child in an institution. 'This decision reinforces the understanding that children with complex medical needs are best served when they can remain at home with their families," said Sam Adams, senior attorney for Indiana Disability Rights. "The court found that there are steps that FSSA can and must take to help ensure these children remain safely in their families' homes.' The lawsuit stems back to the state Medicaid office's discovery in late 2023 that there was a nearly $1 billion budget shortfall, leading it to seek cost-cutting measures. The agency decided it would no longer pay for parents or spouses to care for elderly or disabled loved ones, which is the program referred to as "attendant care." FSSA later moved to a new model that pays service providers a flat daily rate and passes on some of that money to families who care for people. But the new model amounts to a steep pay cut, according to those families. The appeals court decision was, at times, scathing toward the state's arguments in the case. "To state FSSA's argument is to refute it," the decision reads at one point. At another point, the opinion states that the state has "offered only doomsday predictions" that are "difficult to reconcile with the state's apparent willingness to spend the same amount of money or more on other home-based services or to institutionalize plaintiffs and other waiver enrollees." The FSSA didn't immediately reply to IndyStar's request for comment about the impact of the federal court decision.
Politico
8 hours ago
- Politico
Proponent of Medicaid cuts set to brief House Republicans as they plot another megabill
Those staff-level meetings continue as House GOP leaders try to plot a way forward amid skepticism over whether another sprawling domestic policy bill is even possible given the difficulties Republicans had coming to agreement over the first one. House leaders discussed the topic with GOP chairs right before the chamber left for August recess, according to two Republicans granted anonymity to discuss the private gathering, tasking them with compiling lists of possible spending cuts and other ideas. What policies might be addressed in a second package is far from settled, though some House GOP factions are discussing further slashing Medicaid as well as possibly targeting Medicare funding. Blase was allied with conservative hard-liners earlier this year in pushing for significant cuts to Medicaid in the first GOP package. He was the initial author of a letter arguing for 'structural' changes to the program that Rep. Chip Roy (R-Texas) and 19 other hard-right members later sent to their House Republican colleagues. An RSC spokesperson declined to comment on Thursday's briefing. But a person granted anonymity to discuss plans in advance said the meeting is set to cover enhanced tax credits for Affordable Care Act health insurance premiums, which are due to expire at the end of the year, as well as rules governing the percentage of Medicaid expenditures covered by the federal government and reimbursed to states. The briefing will also cover the 340B drug discount program; proposals to even out Medicare payments for outpatient services, known as 'site neutral' payments; plans for expanding tax-advantaged Health Savings Accounts for medical expenses; and arrangements that allow employers to reimburse employees for insurance premiums and medical expenses with pre-tax dollars. Blase, who did not respond to a request for comment, served on the White House National Economic Council during Trump's first term. He and other conservative health wonks launched Paragon in 2021, and it has rapidly gained influence in GOP policy circles. Former Paragon staffers are now top health aides to Speaker Mike Johnson and President Donald Trump.
