My dentist\u2019s office used to be a Mom and Pop operation.\u00a0 Dad and son were both dentists.\u00a0 Mom ran the office.\u00a0 Sister was a hygienist. \u00a0I heard Dad had built the building.<\/p>\n
Mom and Dad retired; sister and her husband started an unrelated business; and one day there was a new logo outside, and my dentist told me he had sold the practice and was now an employee.\u00a0 He was grinning. All the worries of being the employer and landlord were lifted from his shoulders.<\/p>\n
From my years of experience in the murky depths of employment law, I understood his relief.\u00a0 So, I imagine, does every small business owner.\u00a0 Employers have a dizzying number of responsibilities. \u00a0The requirement to meet payroll, which is an obligation under law even if you can\u2019t feed your own family, is only the beginning.\u00a0 You have to be concerned with everything from occupational safety to preventing your employees from making stupid sexually harassing remarks to each other.\u00a0 You are responsible for the insurance, the taxes, and regulations specific to your industry. \u00a0And maintenance of the property.\u00a0 And, finally, doing the work that you\u2019re in business to do in the first place.<\/p>\n
So the recent revelations that some of the providers in New Mexico\u2019s now-decimated behavioral health community had been networked seemed perfectly logical to me.\u00a0 The report said several of the nonprofit agencies that were the object of the state\u2019s audit had belonged to a network, which provided administrative services and paid the salaries of the CEOs. \u00a0The administrator was a high-profile for-profit corporation. \u00a0Was this scandalous?\u00a0 By itself, absolutely not.<\/p>\n
These organizations lived with all the pressures of any small business, and more.\u00a0 Their biggest problem was their biggest customer, government \u2013 for some, the only customer.\u00a0 When you have only one customer, you are at the customer\u2019s mercy and can\u2019t negotiate on anything close to an equal footing.<\/p>\n
Managed care was introduced to this system more than a decade ago, implemented by a contracting company hired by the state; first Value Options, then \u00a0Optum Health.\u00a0 The managed care company\u2019s job is to save money by reducing unnecessary services.\u00a0 But what\u2019s necessary is always a matter of opinion.\u00a0 Some of the clients desperately need those services.<\/p>\n
Was there inadequate management or overutilization before managed care?\u00a0 Were taxpayer dollars being wasted?\u00a0 Possibly.\u00a0 These organizations were founded and run by social workers, not accountants. Maybe managed care introduced beneficial efficiencies. But once those efficiencies were implemented, the managed care company\u2019s job is to continue to produce more savings.\u00a0\u00a0\u00a0 So the behavioral health providers have been squeezed, year after year.\u00a0 I have been hearing about it privately for years\u00a0 \u2013 refusals to authorize payment for services that troubled children really needed, time and resources wasted on excessive paperwork, layoffs forced by budget cuts. \u00a0So some of them hired an management experts to help them squeeze the dollars out of administrative costs? \u00a0\u00a0That sounds not scandalous but prudent.<\/p>\n
An ad hoc coalition supporting the behavioral health community has produced a documentary film, which can be seen on YouTube at http:\/\/youtu.be\/wUSSR_mJYdU<\/a>. \u00a0It is titled \u201cBreaking Bonds, The Shutdown of New Mexico\u2019s Behavioral Health Providers.\u201d<\/p>\n It is possible that the scandal is genuine, that these organizations have been grossly mismanaged or outright dishonest. Until the public knows what\u2019s in the audit, vetted by the Attorney General\u2019s investigation, it\u2019s impossible to know.<\/p>\n Meanwhile, I echo many others in repeating the critical questions:\u00a0 if accounting anomalies were so grievous, why didn\u2019t Optum discover them earlier; and when they were discovered, why did that lead directly to the takeover of the agencies rather than exploratory conversations and less drastic remedial steps?<\/p>\n Triple Spaced Again, \u00a9 New Mexico News Services 2013<\/p>\n","protected":false},"excerpt":{"rendered":" My dentist\u2019s office used to be a Mom and Pop operation.\u00a0 Dad and son were both dentists.\u00a0 Mom ran the office.\u00a0 Sister was a hygienist. \u00a0I heard Dad had built the building. Mom and Dad retired; sister and her husband … Continue reading