La Selva Group:  Offering  better results at a reduced cost

Nearly thirty years ago the concept of “managing care” began to take root and since then it has had profound impact on our health care delivery system.  It is a premise driving changes implementing health care reform today.  Simply put, the idea is that rather than leave health care providers to their own devices, another entity could provide oversight, learning, and perhaps most significant, exercise authority over how much of what type of service an insurance plan would pay for.  The hope back then was the same hope we are banking on today.  We hope it is possible to spend wisely, reduce costs, increase access, and all the while improve outcomes for everyone.  This is very ambitious and indeed may turn out to be folly.  But to not attempt this effort would be guaranteed folly.

Momentum unwittingly began to participate in this experiment around the same time as managed care began to sweep the nation.  We noticed that complex and challenging mental health issues cut across all socioeconomic lines.  Contrary to what you might expect, we also noticed that the public mental health system offered the best benefit package to people facing these difficulties.  At that time commercial insurance plans either offered no mental health coverage or a traditional annual package of 30 days of psychiatric inpatient hospitalization and 20 to 26 outpatient visits with a licensed professional.  While those benefits can be very helpful for many, there are also a significant number of people for whom these options do not meet their needs if the goal is recovery and full participation in life.

The public system not only offers inpatient coverage and private sessions with a professional, but also other essential services necessary if one seeks the best opportunity to achieve health and well being.  The public system also offers residential alternatives to inpatient care.  In addition to the traditional outpatient benefit, the public system includes day, employment, and housing programs.  There is a person to help you navigate the complexities of benefits and community resources.  The help offered focuses on strengths and abilities rather than symptoms and pathology.  It is a better system as demonstrated by both reduced costs and better results.

Recognizing this, in 1983 Momentum began to “market” the same services we offered in the public system to private insurance, managed care companies, and people who could pay out of pocket.  Today, we have La Selva Group that offers a continuum of services similar to what one can obtain in the public system for people who are not eligible for publicly funded mental health services.  It has been a long journey.  While many health care providers were not fond of managed care, it actually benefited the birth and growth of La Selva Group because we are able to offer what payers and customers were hoping to discover: better results at a reduced cost.  La Selva Group has grown considerably over the years.  Today it enjoys an excellent local and increasingly national reputation.  We are in the provider networks for all the major third party payers and better positioned as national health care reform unfolds.  Momentum remains committed to learning and service improvements that deliver high quality outcomes to clients, our community, and the entities that pay for them.  We are moving forward embracing, preparing for, and helping to shape the nature of the future health care delivery system.