In-Network vs. Single-Case Agreements: When a Behavioral Health Provider Actually Has Leverage
Most out-of-network behavioral health providers treat a single-case agreement negotiation the same way: quote a rate, expect a pushback, settle somewhere in the middle. That’s not leverage. Real leverage in an SCA negotiation comes from one specific fact — whether the payer actually has an adequate in-network alternative for that patient’s level of care, not […]
The 2024 Parity Rule’s Comparative-Analysis Requirement: What It Means at the Negotiating Table
The 2024 mental health parity final rule’s comparative-analysis requirement gives behavioral health facilities a documented basis for payor contracting leverage — and that leverage survives even after regulators paused enforcement of the rule itself in 2026. What a Comparative Analysis Actually Requires a Plan to Show A comparative analysis is a health plan’s own documentation […]
Payor Contracting for Behavioral Health: Why the Fee Schedule Isn’t the Whole Fight
Payor contracting for behavioral health depends on walking into a negotiation with real adjudicated-claims data instead of a payer’s opening offer — because that opening offer is set against a backdrop where behavioral health is reimbursed well below the cost of delivering the care. That’s not a negotiating tactic talking point. It’s a documented, industry-wide […]