Why Traditional Financial Models Get Behavioral Health Revenue Wrong
A financial model built on the fee schedule looks precise: multiply expected volume by the contracted rate, get a revenue number. That number is usually wrong, because it treats the fee schedule as the revenue a facility actually collects, instead of the ceiling on what it might collect if every claim paid in full and […]
Modeling Expansion: What a New Location Needs in Reimbursement Runway Before Break-Even
A break-even model for a new location usually assumes one ramp: X months of losses, then profitability. That single number hides the real driver of how long the runway needs to be. Every payer credentials a new location on its own clock, and the slowest one — not the average — is what determines when […]
Building a Collections-Based Forecast Instead of a Fee-Schedule Forecast
A collections-based financial forecast for behavioral health starts from what a facility’s payers actually pay after denials and underpayments, not from the fee schedule they’ve contracted to pay — and the gap between those two numbers is usually the difference between a forecast that holds and one that doesn’t. Why the Fee Schedule Overstates What […]
Financial Modeling for Behavioral Health: Why the Fee Schedule Isn’t the Revenue Number
Financial modeling for a behavioral health facility depends on forecasting cash collections against what payers actually pay, not what the fee schedule says they should pay — and for behavioral health specifically, that gap between contracted rate and real-world reimbursement is often wide enough to break a forecast built without it. A revenue forecast built […]