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UCLA: Behavioral Health Network Augmentation

Introduction

UCLA, a globally recognized institution, boasts a comprehensive medical delivery system. However, it faced challenges in its behavioral health (BH) vertical, with issues stemming from an inadequate network to address the diverse mental health needs of its patients. This case study outlines how Carenodes partnered with UCLA to enhance their BH network, yielding significant improvements in patient care and business outcomes.

Project Overview

Project Title: UCLA - Behavioral Health Network Augmentation

Issue: UCLA's existing behavioral health network was overwhelmed, unable to meet the increasing patient needs. This led to regulatory compliance challenges and a substantial backlog of patients requiring mental healthcare. On average, UCLA, with its 35 on-staff providers, could handle only 50 of the approximately 300 new patients seeking care daily, necessitating an additional 75 providers.

Solutions and Implementation

Carenodes stepped in to address this shortfall through a strategic collaboration. Key actions included:

  1. Expanding Provider Network: Carenodes contracted 30 additional providers, significantly expanding UCLA’s capacity to handle behavioral health cases.

  2. Negotiating a Strategic MOU: A Memorandum of Understanding (MOU) was negotiated, leveraging UCLA's influence in payer negotiations. This MOU focused on streamlining authorizations and included provisions to maximize revenue while minimizing administrative costs.

  3. Enhancing Patient Referral System: The partnership led to a more efficient referral system, ensuring timely patient care.

Results

The collaboration between Carenodes and UCLA yielded remarkable results:

  • Increased Capacity: The addition of 30 providers from Carenodes enabled UCLA to significantly reduce its patient backlog, improving both service quality and compliance with healthcare regulations.

  • Financial Impact: The deal resulted in approximately 100 new patients daily, translating to an increase of about $500,000 per month in new business.

  • Strategic Partnership: Carenodes became a key partner with UCLA, not only expanding the BH network but also contributing to broader business growth.

Conclusion

This partnership exemplifies how Carenodes’ solutions can effectively address gaps in healthcare provision, particularly in the behavioral health sector. The collaboration with UCLA demonstrates Carenodes’ commitment to enhancing healthcare delivery through strategic partnerships, innovative solutions, and a focus on both patient care and business efficacy.

This case study serves as a testament to Carenodes' ability to work with major healthcare institutions, aligning our expertise in behavioral health with the needs of a world-class medical provider to create mutually beneficial outcomes.

Note: This case study is for informational purposes and reflects the project as of the date of publication.