Greg Keilin and Mike on Importance of Compliance and Changes in Compliance Landscape

What if there was a key to improving health care outcomes right at your fingertips? In this episode, we are diving headfirst into the importance of behavioral health compliance and the impact it has on the industry. Join us as we discuss the changing legislation and its potential effects, specifically the impending vote on recovery residence licensing in Texas. Our guest shares valuable insights on the significance of data collection and compliance in providing optimal care and choosing the right patients for your organization. 

Transcript

Speaker 1: 0:00

Welcome to Hatching Creativity. This isn't just another behavioral health podcast. This is the place where thought leaders converge to talk about real life challenges, breakthroughs and pivotal aha moments.

Speaker 2: 0:17

Compliance landscape is changing. It's something that's been a theme in our podcast as well. You know the professionalization of the management in the industry. You know what changes are you seeing in the compliance landscape in the last few months, especially since the beginning of 2023? And how are those impacting the providers that you work with you?

Speaker 1: 0:35

know it's kind of funny. When I first started with Hatch in 2018, I remember somebody said to me nobody gives a shit about compliance, and I remember being bothered by it because I felt that it was really important. And I would say the biggest thing going on right now relating to my area of health care behavioral health compliance is that people are really paying attention to it. Now you know they recognize that compliance is a key to improving outcomes, because if you can't track what you're doing to get the outcomes, how can you fix something that's not working or how do you replicate it right? So we're seeing people putting more emphasis on compliance. We're also seeing there's some legislation around it. So Texas is getting ready to vote on a requirement that recovery residences become licensed, which is something that Florida has required, and there's a few other states that do as well, and I think that is going to be important and that's something to be looking at.

Speaker 1: 1:45

And the other big thing as it relates to compliance and you're seeing a big push from the Joint Commission as well as from the health insuring payers is health care equity. And health care equity is really coming to the forefront this year Again, as they're starting to research social determinants of health and the disparity in communities that are getting treatment. There's going to be some really big discussions around that, too, and I'm excited to see what changes. Compliance is a key to improving health care and as it becomes more important to more people, we're going to see better innovation, better ideas, and some of the things that we're working on will most likely be getting standardized.

Speaker 2: 2:35

Yeah well, so there's a whole bunch there, mike, that I want to follow up on, but the first one that I think is really important and I've had conversations with you and others about this, but I think it's really a topic that hasn't gotten a lot of airtime in our industry until very recently is this equity question, and so I would love just, I think, in the spirit of educating our listeners like if you could talk a little bit more about what does that mean and how is it impacting? You know, compliance and operations for behavioral health care providers.

Speaker 1: 3:08

Look in every aspect of culture and life there's disparity and it's based on usually anything from race to gender, to where you live, age and many other factors. What the payers and the states and the regulating agencies are trying to do is uncover where there is disparity as it relates to these demographic questions, and then they want to be able to look at that and see how certain groups may be getting less, certain groups may be getting more, certain things may work for different demographics of people that don't work for others. So you know, this industry has always been very amorphous as it comes to the information, because we hadn't really been collecting data, and you know I spoke with you about this a couple weeks ago. The only data that most organizations are looking at is going to be around maybe their billing, because that's their wallet, and maybe marketing data, but there is so much more that can be looked at and quantified to see if you're providing the best care that you can. You know a side topic is I was talking with Glenn Hadley from Dreamscape and you know the conversation was around value-based care and the thing is is if you're getting paid for your results.

Speaker 1: 4:39

You don't want to treat everybody right. You want to have the filter of the clients that are best for your organization and this way you're having your best chance of success with that client. You're also having the best chance that you're going to get paid for whatever that treatment episode is, and the reason I mentioned that is it all comes full circle to the data. If you're collecting your data, then you're going to actually have much better idea of who you should and who you should treat and who you should refer.

Speaker 2: 5:10

This is definitely a recurring theme in my conversations recently too, mike. The idea of you know the one size fits all solution is not. We all know that one size doesn't fit all right, and so in most contexts really, but for sure in the treatment context and you know, one conversation that we are having with our clients all the time, especially when we're talking about in-network contracting, is what do you do differently? What's your unique selling point? Who do you work with that? This payer, you know, needs help servicing.

Speaker 1: 5:43

You mean? Your unique selling point is not that you have a view of the lake or your rooms are painted with clouds on the ceiling.

Speaker 2: 5:49

Well, listen, those might be valuable selling points for certain. You know, in a certain context, If you can tie those to outcomes as to your point right, If you can quantify the impact of that great, or if you're appealing to a private pay audience where they value comfort and luxury, that can also be very valuable. So I don't mean to diminish the value, you know, trivialize the value of those things, but I definitely think that you know it's exactly what you're describing, that you know figuring out what you do well and focusing on that and executing against that. I think it's a compliance point, it's a revenue cycle point, it's a clinical point, it's one of the things. I'm also going to get up on my soapbox here for a second and talk about the interconnectedness of all of these areas of operations.

Speaker 2: 6:33

You can't just talk about billing or compliance or clinical or marketing in a vacuum. They are all related to all you know. Everything is related to everything else.

Speaker 1: 6:41

Yep, you know it's funny. I remember, do you remember we used to have video stores that you would go to to pick up videos, right? And there was a video store that was right down the street from my school when I was in high school, and they had all these B movies and I love B movies Like the cheaper, cheesier, the better, right. And there was one movie and I remember there was like aliens invaded and the guy worked at some convenience store or whatever and there was a quote everything matters. And that was like the whole thing, that was the whole topic of this movie, and so everything matters, everything matters, and it's kind of funny because that's exactly what you're saying. It made me think of that, as just you can't just skip something because it's a pain to do. You know, you have to have good people around you with varied skills that you can count on to do the things that you don't want to do, and you will really pay for your time as well as the quality of work that you put out.