“Now I Can Buy Groceries!” What Insurance Coverage vs. Cash for Addiction Treatment Means to Patients
Apr 23, 2019
I recently had the privilege of meeting Bradley Helton, the caring owner of The Bradley Center in South Louisville, KY. Located in one of the zip codes hit hardest by the opioid epidemic in Kentucky, the Bradley Center offers medication-assisted treatment (MAT) and wraparound services for opioid addiction.
Brad and the facility he runs are beacons of hope amidst an area plagued by overdose deaths. But because of the onerous hurdles to qualify for state credentialing, the Bradley Center could only provide services on a cash basis.
Two months later, CleanSlate has acquired the Bradley Center and can now offer coverage for its services through Medicaid or commercial insurance.
What that means for patients is profound.
This isn’t a corporate story about an acquisition. It’s a human story about the costs of treatment and the challenges facing small businesses and individuals to offer and receive life-saving care.
$300 in a patient’s pocket = joy
At the beginning of this month, the Bradley Center opened its doors to patients under the CleanSlate banner. As longtime patients learned that – for the first time – insurance would cover the cost of their treatment and they no longer had to pay $300 per month, they reacted with confusion. And then amazement.
I was humbled by their responses.
You’re kidding, right? said one patient. Now I can buy groceries!
You don’t know what a blessing this is, another patient told me. I can catch up on my car payments.
My son’s birthday is this month, said another patient. Now I can give him a card with money in it. I didn’t think I could give him anything.
Now I can get my car fixed! said someone else. I didn’t know how I was going to do that before.
Brad and I received hugs, tears of gratitude, and many stories about how this one small step would help patients improve their lives. Every patient thanked us.
As word spread that the Bradley Center was now accepting insurance, multiple calls came into the center on that first day to schedule appointments.
Related blog: In Area With Highest Overdose Death Rate In Kentucky, CleanSlate And The Bradley Center Combine Forces To Battle Opioid Epidemic
The story of one patient, Jonathan, was particularly touching.
Jonathan is a patient that my colleague Mike and I thought would never show up the first time he called the clinic, said Brad. He was a mess. High, crying, and begging for help. Jonathan was coming from Shepherdsville, about an hour away. Mike and I never thought he would make it to his first appointment.
They were wrong.
After his first induction in late 2017, Jonathan became a great patient at the Bradley Center. Since then, he has made gigantic strides in his life and has been in recovery for over a year.
Jonathan used to live in his parents basement. He’s a single father to a little girl, and Jonathan’s parents had temporary custody of her when he initially asked for help.
Today, Jonathan has his own house where he pays the bills. And he was able to get his daughter back.
(Pictured: Jonathan Pike with his daughter and Brad Helton.)
Jonathan’s little girl is so smart and polite, said Brad. Very sweet and grateful. She loves coming here with him because she knows we will spoil her. She starts school in the fall and couldn’t be more excited.
Here’s what insurance coverage for MAT means to Jonathan.
Jonathan told us that he can now afford to buy his daughter school clothes, said Brad. And he can get her the shots required for her to start classes. He said that he will have extra income now to do things with her that he couldn’t do before.
Things like going out for dinner.
As Jonathan and his little girl walked out of CleanSlate, he told Brad that they were headed to Chuck-E-Cheese for games and pizza.
They’re both such grateful human beings, said Brad. Everyone here at Louisville South loves them.
Related blog: “I Have Stepped Out Of The Darkness, Into The Joy Of Living Again”: One Patient’s Account Of CleanSlate’s Alcohol Treatment
Small treatment centers can’t afford costs of credentialing
Why couldn’t the Bradley Center accept insurance before being acquired by CleanSlate?
As much as Brad wanted to receive the proper state credentialing so that his center could qualify for insurance and Medicaid, the hurdles to do so made this goal daunting.
Brad was told that the credentialing process would be a steep six-figure cost and would take seven to eight months. During that time, the Bradley Center would be legally prohibited from accepting cash payments.
Even after receiving this certification, there are still challenges of becoming a treatment center that doesn’t accept cash. Medicaid and many commercial insurance providers are often slow to reimburse for services, adding to the burden on small business owners.
It’s an impossible situation for a small business, said Brad. I don’t even care about the money. I’m not in this for the money. We never turn away patients – we will treat them for free if we have to. But I still couldn’t make it work for that period of time and come up with that kind of cash for the credentialing.
Brad sought out financial partners who could help underwrite the credentialing costs, but private investors wanted half of his business in exchange.
Our Attorney General, Andy Beshear, doesn’t believe in cash clinics. He thinks that every treatment center should be credentialed. I agree. But the state makes it impossible to get over the hump unless you’re a big corporation or a doctor who has a lot of personal income to do it yourself.
The flaws in our healthcare system that make it difficult for small treatment centers to provide cost-effective care are pervasive and stubborn. These flaws won’t get fixed overnight – if at all.
But the patient stories coming out of the former Bradley Center, now CleanSlate, remind us what’s at stake when ordinary people have access to high-quality, affordable addiction treatment.
A working car.
A birthday card.
New school clothes.
Pizza night with a daughter.
CleanSlate treats patients suffering from opioid or alcohol addiction with medications and a continuum of care to support each individual’s journey to recovery. If you or someone you love needs help, contact us at 833-505-4673, or visit our website at www.cleanslatecenters.com to find the center nearest you. Learn more about CleanSlate’s South Louisville addiction treatment center.
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Recovery from addiction includes recovering trust.
Download our free Pocket Guide to learn more about the emotional challenges that many patients face on their road to recovery.