Networking for Behavioral Health Providers
Joining a network of behavioral health providers can alleviate common burdens such as limited clientele and complex billing processes and can also increase accessibility of care and affordability for those who need it most. At Advocates for Human Potential, Inc. (AHP), our experts are ready to assess your best options, connect you with the right network model, and help you plan for the transition and launch of your new network status.
For over 35 years, AHP has been improving health and human services systems of care to help organizations and individuals reach their full potential. Our consulting, technical assistance, research and evaluation, and administrative services are tailored to support our clients’ vision for a network status that suits their evolving needs.
Benefits to Forming a Network
Being part of a provider network allows members to share administrative and financial costs and can help your organization
- Build for managed care and value-based reimbursement,
- Standardize and optimize quality,
- Enhance continuity of care, and
- Address population health and social determinants of health (SDOH).
Choosing the Right Network Model
Provider network models range from low-risk, low-reward management service organizations (MSOs) to higher-risk, higher-reward independent provider associations (IPAs).
MSO Services
- Practice and case management
- Billing and collections
- Information technology
- Quality assurance; credentialing
- Human resources; workforce development/training
- Marketing, public relations, and call centers
IPA Services Include All MSO Services, Plus
- Insurer/managed care negotiations
- Contracting and claims management
- Actuarial analysis
- Assumption of financial risk (capitation)
- Benefits management
Our team can help identify and address your needs regarding the following:
- Information technology/information systems (IT/IS) infrastructure, such as expert staff, hardware, management IS software, training, information exchange/electronic data interchange, and telecommunications
- Compliance, including subject matter expertise, policies, and procedures
- Quality, such as reporting requirements, staff, policies, and procedures
- Licensure and legal issues, including third-party administrators (TPAs), managed care organizations (MCOs), contracts, and risk management
- Accreditation, including from the Commission on Accreditation of Rehabilitation Facilities (CARF), The Joint Commission, URAC, and the National Committee for Quality Assurance (NCQA)
- Capital, risk, and reserves, such as stop-loss/reinsurance (underwriting, actuarial subject matter expertise, and financial systems/data warehouse)
- Structure and governance, including your executive team, board, management, staff, and provider/member committee
- Physical infrastructure, such as office space and call center
AHP employs a time-tested process to get you from “thinking about it” to “launch ready” in 18 to 24 months.
About Us
Advocates for Human Potential, Inc. (AHP) creates powerful solutions to improve health and human services systems. By partnering with the federal government, states, municipalities, healthcare systems, and nonprofits, we help people experiencing the greatest disadvantages lead full and productive lives. We are national leaders in training and technical assistance, research and evaluation, publishing, and dedicated consulting. On issues from workforce development to mental health, substance use disorders to housing and homelessness, we help our clients enhance behavioral health care through systems change. AHP was founded nearly 40 years ago to develop solutions for some of the biggest social infrastructure challenges across the nation. Our company has offices in metro Boston, Chicago, and Los Angeles. Find out more at www.ahpnet.com.
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