Over the last eight years, as Vista’s research software has been used to monitor 85,000 patients throughout treatment and follow up with 30,000+ afterwards, we’ve continually innovated to provide our clients with useful, easy-to-understand patient dashboards and data analytics. During the last two years, we improved our annual report-generating abilities and introduced two new reports, a Payer Summary Report for use in payer negotiations and a Prospective Patient Report to showcase a program’s impressive results on their website.
We’ve done the basics, and we’ve done them really well. In 2024, we plan to take our research to the next level by helping our treatment center clients with four of their biggest challenges.
Negotiating with Payers
In numerous discussions with treatment center leaders over the last several months, I’ve heard horror stories about how they’re being squeezed financially. Staff costs have commonly increased by 12% to 35% since the start of the pandemic, but many payers are refusing more than minimal reimbursement rate increases. Multiple centers have told me that their biggest payer has refused to increase their reimbursement rate at all since 2020.
The nonprofit I co-founded is working on a long-term project to use claims data to identify the payers and providers whose members and patients are receiving the most effective addiction treatment. However, the Conquer Addiction Moonshot is years away from achieving its goal of bringing transparency and accountability to addiction treatment. In the meantime, Vista is focusing on helping our treatment center clients use their data to negotiate effectively with their payers.
The first step in negotiating with a payer is being able to show them strong recovery statistics for its members who attended your center. We’re helping Vista clients accomplish this by creating Payer Summary Reports that summarize the key metrics payers are most concerned about for members of a particular payer. If you have a payer negotiation coming up, please request us to produce a report for you; there’s no charge.
Long-term, we believe that value-based agreements will be the best way for our clients to ensure that they’re appropriately compensated for providing high-quality care. We are working on a guide for how to negotiate these types of agreements that incorporates our experiences helping clients do so.
One of the biggest pain points in the therapeutic world has been how much time clinical documentation takes to do well. We want to reduce this burden by building a proprietary AI tool that uses Vista survey data to create the first drafts of progress notes and, perhaps, portions of the treatment plan. These easily-editable drafts will follow best practices for clinical documentation and will prompt the clinician for specifics as well as suggesting potential options. Our aim is to roll out a preliminary version of this feature by the fall.
If clinical documentation is something you’re passionate about, we’d love to have your help on this project. Please reply to this email to let me know you’re interested.
Continually Improving Post-Treatment Outcomes
My driving force in creating both Vista Research Group and Conquer Addiction has been to help families find effective addiction treatment. Educating families on how to find rehabs that have proven their treatment works is the key message in my recent TEDx talk, How to Get Your Child Back: A Parent’s Guide to Battling Addiction.
During five years of announcing Conquer Addiction’s Excellence in Treatment winners, it’s been interesting to watch the outcomes of many centers improve over time. Peter Drucker was right when he said, “What gets measured gets managed”.
But lately, we’ve run into a problem. We’ve been paying the same amount for post-treatment surveys since we started outcomes research in March 2016 -- $5 for one-month surveys, $10 for six-month surveys, and $15 for twelve-month surveys, plus another $5 if a former patient responds to our first request. In the last few years, we’ve started to hear complaints that we’re not paying enough.
Frankly, $5 doesn’t buy what it did eight years ago at Starbucks or Target. And if patients don’t fill out a one-month survey because they think $5 isn’t worth their time, they’re less likely to fill out the crucial six and twelve-month surveys.
Therefore, we’ve decided to increase the amount we pay former patients to submit each survey by $5 on February 16, 2024. Simultaneously, we’re going to increase what we charge clients for each outcomes survey from $33.33 to $40.00. (Side note: if you’ve been planning to start using Vista but have been putting off making a decision, now is the time. New clients who sign up before 2/16/24 will be grandfathered in at the current pricing for a year).
Predicting Patients at Highest Risk of Leaving AMA
There are numerous factors that increase the risk that a patient will leave treatment early. Among the biggest risk factors are the age of the patient, their primary drug of choice, the overall AMA rate of the program, whether a patient has ever left treatment AMA before, and how engaged they are with treatment as evidenced by the frequency with which they submit Vista’s surveys and the type of comments they make.
Creating a model that accurately predicts the patients at highest risk of leaving AMA is devilishly difficult, and we’ve failed at two previous attempts. However, we believe this could be so useful for our clients that we’re going to tackle it again in the 3rd and 4th quarters.
So this is our preliminary “road map” for 2024. I’m taking the risk of publicizing it because I want to make sure we’re working on the most important projects. We exist to help you – our clients – provide the best possible treatment to your patients. If there is something even more important that you think we should be working on, please let me know!
Finally, thank you for the tremendous work you do helping patients with addiction and/or mental illness recover. We are honored to be partnering with many of the best treatment centers in the U.S.