Rethink Behavioral Health announced a new medical necessity assessment (MNA) analytic tool to help clinical professionals prescribe appropriate levels of applied behavior analysis (ABA) therapy for children with autism. The MNA solution allows a Board Certified Behavior Analyst (BCBA) to enter diagnostic factors for an individual, then the solution synthesizes that input with supporting evidence and research, to produce a suggested dosage range of treatment hours based on evidence.
ABA emerged in the 1990s as a promising treatment for autism, but at that time few insurers covered it and there were few resources for determining the medical necessity for the number of hours or sessions needed by an individual. Since 2010, most health plans have started covering ABA, which has required the BCBAs who deliver ABA therapy to demonstrate medical necessity for the specific level of intervention.
As a comprehensive electronic medical record and practice management platform solution to more than 600 behavioral practice groups across the United States, Rethink became aware of the need for an evidence-based standard for determining medical necessity for ABA. “There has never been a standard protocol available for determining how many hours of care should be delivered to a child based on their specific needs,” said Jamie Pagliaro, executive vice president and chief learning officer for Rethink Behavioral Health. “We designed an evidence-based assessment that may help reduce friction between providers and health plans, ensuring more children receive clinically appropriate levels of care.”
To develop the MNA solution, Rethink worked with an expert panel, and tested the solution in more than 6,000 individual assessments with clinical professionals nationwide. In tests, the clinical professionals agreed with the recommendations of the Rethink MNA solution 70% of the time. Most instances of disagreement were due to functional issues, such as scheduling or transportation availability for families.
Rethink Behavioral Health offers all-in-one, technology-based solutions to behavioral health professionals, including video-based training for registered behavior therapists, ABA data collection tools and practice management solutions to meet market demands. It is a division of Rethink First, a global health technology company providing cloud-based treatment tools, training and clinical support to schools, employers, behavioral health professionals and payers.
Rethink serves thousands of consumers globally, including more than 25 of the Fortune 100 companies and many of the country’s largest public school systems and health plans. Rethink’s SaaS solutions are powered by proprietary, clinically validated content and best practices overseen by a renowned Scientific Advisory Board and include more than 2,000 evidenced-based training modules, extensive Social and Emotional Learning content and ground-breaking neurodiversity and inclusion training and education tools. Rethink is owned by K1 Capital, a private equity firm focused on high-growth, enterprise software solutions.
This was reported by Rethink Behavioral Health on April 6, 2021.
Contact information: Eric Masters, Chief Marketing Officer, Rethink First, 49 West 27th Street, 8th Floor, New York, NY, 10001; 877-988-8871; Email: firstname.lastname@example.org; Website: www.rethinkfirst