Healthfirst Partners with Samaritan Daytop Village for Behavioral Health Bundle

Crain's Business New York "Health Pulse"
June 26, 2019

By Jonathan LaMantia

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Samaritan Daytop Village, which offers treatment for substance-use disorder, has been working with the insurer Healthfirst on a care model that provides a single payment per case for a three-month outpatient treatment period.


Healthfirst START article

Stock photo credit: Crain's New York Business

Through the Substance Use Therapy and Recovery Treatment, or START, program, Healthfirst members can receive care for mental illnesses as well as recovery services for addiction to opiates, stimulants, benzodiazepines, alcohol or cocaine.

The program is designed for people who don't need to be hospitalized and can receive services in the community on an ongoing basis, said Ian Shaffer, executive medical director of behavioral health at Healthfirst. The insurer could see savings if its members stay in treatment and avoid readmissions to the hospital for detoxification, he said, and sobriety could improve their quality of life.

"What we're talking about is something you don't see a lot of in the state of New York, which is full treatment of substance use as an outpatient," Shaffer said.

Samaritan Daytop Village is working with Uber for Business to provide free transportation to patients from wherever they are seeking care to its outpatient program in Jamaica, Queens. At the Jamaica site, they can receive psychiatric services, detoxification and medication-assisted treatment from a care team that includes doctors, nurses, psychologists, social workers and peer recovery specialists.

"They don't have to come to us. We'll come to them," said Mitchell Netburn, president and CEO of Samaritan Daytop Village. "It's not inconceivable they could be on a street corner."

The Jamaica site will be the main location for services, but patients can continue accessing services at the nonprofit's outpatient sites in the Bronx, Brooklyn and Manhattan.

Clients who participate in the program also can get free car rides to appointments and vocational services.

Samaritan Daytop Village received assistance from Coordinated Behavioral Care, a coalition of behavioral health nonprofits, in crafting the payment model with Healthfirst.

The program will track outcomes including clients' responses to depression surveys, toxicology, retention and engagement in the program. "It's not only centered on relapse," said Carolann Slattery, Samaritan Daytop Village's vice president of outpatient services.

Healthfirst will help the nonprofit measure the effect the program has on hospital use and emergency room visits.

The insurer will provide payment for 90 days of services through the START program, with fees varying depending on the intensity of services a member needs. After the 90-day window, it will pay for any services provided individually.

Netburn said the partnership with Healthfirst differs from how it works with other insurers in that hundreds of the insurer's case managers will be looking to refer members to Samaritan Daytop Village.

"They've removed barriers like authorization," Netburn said. "It will be quicker, smoother and in more real-time."

Shaffer said reimbursing addiction providers only if they provide a set number of services can lead to a treatment plan that's not appropriate for each individual.

"What we like about it is it lets them tailor the clinical delivery to what that individual needs at that moment in time over three months," he said. —Jonathan LaMantia