Addiction PHP Creation

[TexasPhysician]

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Has anyone started an addiction PHP program from the ground up? Any recommended resources! How difficult is this to create with insurance companies? What kind of terror am I in for?

 

[oldiebutgoodie1211]

How are you gonna do this aren’t you a cash private practice guy?

 

[TexasPhysician]

How are you gonna do this aren’t you a cash private practice guy?

Im too entrepreneurial to only have 1 job at any given time.

 

[WisNeuro]

If our metro is anything like your area, you'll fill up in no time. In my hospital job setting we have an addictions PHP program they started in the last couple of years. We have a long waiting list as this option does not seem too prevalent. I don't have much to do with it, so I don't know specifics other than it seems to be a high demand service. So, if you can find a way to make it pay well, should be a consistent revenue stream.

 

[NickNaylor]

Whether or not this is a function of working in a bureaucratic system or something else, I can tell you that our large, academic institution has had significant difficulty maintaining an IOP, much less a PHP.

 

[Sushirolls]

They can be profitable. But dependent on patient volume and insurance coverage. Now you need insurance auth for this.

Uniquiely for SUDs, is an additional layer of insurance auth issues, then on top of that a higher no show rate for the patients.

Furthermore, why go to your PHP/IOP if there is no detox? Nor inpatient? If you are willing to go all in for Detox/Rehab/PHP/IOP/Therapy aftercare, then you have a model that can capture people at their willingness AND insurance willingness.

SUDs has stiff competition with national companies advertising heavily.

Are you sure this is something you want to gamble on? Perhaps if you are heavy in meth or cocaine or some other pocket you might be able to target your local flavor of SUD, but even then, many of the folks with Crack/Meth have picked up medicaid insurance. That opens up its own issues.

Good luck if you try it! I won't be clamoring to do so anytime soon in my area.

 

[dl2dp2]

I'm not sure actually agree with a few posters the above saying this is a good idea. I have a feeling that tier one metros are oversaturated. This is not a very easy profit center.

1. Lots of patients would be interested, but mostly request will be with (bad) insurance/Medicaid.
2. If it's insurance/Medicaid, reimbursement is not paying well. Would need to manage a large team of CASACs/LCSWs to derive high profit margin.
3. There's some money to be made in doing medication assisted therapy / medication for opioid use disorder, but this is at the MD/medical director level. I don't see an advantage vs. just a single physician practice.
4. Cash (non-insurance) programs CAN be lucrative, but this is where things are tricky: since you are competing with a small pool of patients, and PhDs/LCSWs can start these programs, you have little competitive advantage. In tier one metros you are competing with programs that have longstanding histories. In tier two metros (~ Charlotte, NC, San Antonio, TX, etc) I think opportunities exist, but isn't easy by any means.

Have you considered starting a nonprofit? I think that's a better fit for this kind of work, and I think most of the high executive compensation would come from managing large carve-out contracts, especially if there are other components (i.e. training, etc.) collaborating with academic centers, etc.

 

[TexasPhysician]

They can be profitable. But dependent on patient volume and insurance coverage. Now you need insurance auth for this.

Uniquiely for SUDs, is an additional layer of insurance auth issues, then on top of that a higher no show rate for the patients.

Furthermore, why go to your PHP/IOP if there is no detox? Nor inpatient? If you are willing to go all in for Detox/Rehab/PHP/IOP/Therapy aftercare, then you have a model that can capture people at their willingness AND insurance willingness.

SUDs has stiff competition with national companies advertising heavily.

Are you sure this is something you want to gamble on? Perhaps if you are heavy in meth or cocaine or some other pocket you might be able to target your local flavor of SUD, but even then, many of the folks with Crack/Meth have picked up medicaid insurance. That opens up its own issues.

Good luck if you try it! I won't be clamoring to do so anytime soon in my area.

It would be all outpatient detox, php, iop, etc with patients coming in for their appointments. The inpatient centers near me seem to be folding up shop. Inpatient is too hard to get insurance approval it seems. I would think the logical step is for outpatient programs to fill this void. Has it already been filled? I may be wasting my time.

 

[Sushirolls]

Do some recon, call up the local options yourself and talk with the front desk staff. Wait times, insurance, say you have the good insurance and your cousin has XYZ and might need services, too.

 

[dl2dp2]

Do some recon, call up the local options yourself and talk with the front desk staff. Wait times, insurance, say you have the good insurance and your cousin has XYZ and might need services, too.

You may be also interested in the story of the only public company in this space--google it: American Addiction Centers. They were delisted on NYSE last year and was a favorite of OTC short sellers. The company currently has a market cap of <20M against a revenue of over 250M. Very interesting. I'm pretty certain that a nice single site facility like Passages Malibu have a higher private market cap. Most of the well known players (Hazelton Betty Ford, Caron, etc) are non-profits. The trick there is often auxiliary profit streams (i.e. owning commercial real estate, etc) since the primary business is not a profitable entity.

Also, I'm seeing **** this like daily on my FB/Instagram:

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Your personal online therapist & doctor. $25 per video appointment with insurance. Schedule visits, get prescriptions, build lasting care.

joinmonument.com

Would you take a patient for $40 a month?