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Terry McLeod of ehrSIO ProjectsehrSIO Projects
A blog about the technical and software sides of mental health and addictions

Making the Rent and Still Recovering

Terry McLeod Updated: Nov 23rd 2010

America recently swapped out a number of Democrats for Republicans with the promise to voters of decreased government spending. As a result, a number of mental health and addiction treatment facilities could face increased hardship. Their primary source of paying the rent is drying up...Medicaid funding looks to be continuing a downhill slide.

calculator pen and formsOnce again, mental health and addictions facilities are faced with improving the way we do business and securing alternate revenue sources. Every time this challenge has arisen over the past couple decades we've overcome it by improving the way we do business. I'm particularly grateful about this because it's allowed me to make a living helping these folks become more efficient and effective by using the Electronic Health Record (EHR).

I tend to agree with Chuck Ingoglia, Vice President of Public Policy for the National Council for Behavioral Healthcare (NCCBH), when he forecasts that Medicaid funding in our business is likely to decrease over the next few years.

So, as Medicaid dollars shrink, the agencies need to make up for that somewhere, and as the old story goes, it's better to teach somebody how to fish than simply give them their next meal.

One way to make up for losses in funding is to sharpen up with better use of the EHR. A number of mental health and addictions treatment providers are trying to make better use of their software by encouraging use of central management of practitioner scheduling in order to make sure their workload increases. As that workload increases, collaborative documentation, writing the notes and developing treatment plans as part of a therapy session becomes more a part of daily business. Just using the EHR this way leads to shorter wait times for a consumer to see a professional for the treatment they need, and helps focus on the problems in the treatment plan rather than digressing into the crisis of the moment with no direction toward recovery.

Facilities taking care of business with creative measures like this will survive, and some of them will flourish.

Recent gains made in healthcare reform will face some losses, and popular mandates like mental health parity that assures insurance companies must pay mental health and addictions claims on par with physical health claims will likely stick around. Consumers who benefit from reform measures are more easily motivated to write their legislators and encourage them to support reform gains.

For the past couple years, a number of mental health and addiction treatment facilities have been successfully weathering business changes required by decreases in their funding. A small rehab in Wisconsin survived long enough with a grant in order to implement enough of the EHR to assure they collected payments (or at least partial payments) from self pay consumers…sometimes that's as simple as asking for a payment at the time of service. Before the EHR, they simply had no working system to do that. A mental health provider in the Midwest lost their grant funding and started reaching out to gain new self-pay and insurance consumers. They instituted sliding fees where they were warranted, and tracked accounts for this new way of doing business with their EHR. They aren't flourishing, but they're still helping people as a result of these marketing and business changes.

These are examples of a fighting spirit. These are people willing to make significant changes and a few sacrifices in order to continue helping others recover from mental health and addictions problems. Lately I've been helping a couple agencies switch from one method of funding to another, and in the process, helping them make better use of the EHR. Ten years ago, staff would have groused and fought the change. Now, I'm met with growing enthusiasm. You know you're making headway in the battle to succeed when the troops lead the way into change.


Terry McLeod

Electronic Health Records (EHRs) are a required part of our society, and improving business workflows with the EHR is imperative for the survival of your local mental health and addictions treatment clinics. Terry McLeod provides the bridge between the mental health and addictions professional and the technical world, as well as the glue to keep it working. Contact McLeod at and get more information from his website and blog,

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