JLW RESEARCH &
PAYER ACCOUNTABILITY INITIATIVE
EXAMINING PAYER REIMBURSEMENT DISRUPTION AS A PUBLIC HEALTH CRISIS
JLW Medical Management Consulting is conducting multi-state research examining whether payer reimbursement disruptions, including denied claims, delayed payments, underpayments, prolonged reprocessing, and unresolved payment disputes, contribute to financial instability among behavioral health organizations and, ultimately, reductions in workforce, treatment capacity, patient access, and continuity of care.​​
WHAT HAPPENS TO HEALTHCARE ACCESS WHEN CARE HAS BEEN DELIVERED, BUT PAYMENT DOESN'T FOLLOW?
WHY THIS
RESEARCH MATTERS
01
PAYER PAYMENT DISRUPTIONS MAY EXTEND BEYOND REVENUE CYCLE OPERATIONS
When reimbursement for services already delivered is denied, underpaid, or significantly delayed, the financial consequences may affect an organization’s ability to maintain staffing, operations, and clinical capacity.
03
WORKFORCE DISRUPTION MAY REDUCE ACCESS TO CARE
Hiring freezes, reduced clinician hours, unfilled positions, layoffs, or turnover resulting from financial pressure can translate into fewer available appointments, longer wait times, and reduced treatment capacity.
05
THE SCALE AND RELATIONSHIP BETWEEN THESE EVENTS REQUIRE BETTER EVIDENCE
While individual practices report reimbursement challenges, this research seeks to systematically quantify the frequency, magnitude, duration, and downstream consequences of payer reimbursement disruption across behavioral health organizations.
02
FINANCIAL INSTABILITY CAN BECOME A HEALTHCARE DELIVERY ISSUE
Behavioral health practices rely on predictable reimbursement to meet payroll, retain clinicians, maintain programs, and continue accepting patients. Prolonged payment disruptions may place those functions at risk.
04
PATIENTS MAY EXPERIENCE THE CONSEQUENCES OF PAYMENT DISPUTES THEY NEVER SEE
When practices reduce services, close panels, leave payer networks, or discontinue programs, patients may experience treatment interruptions, provider changes, delayed access, or difficulty locating alternative care.
06
PUBLIC HEALTH POLICY REQUIRES EVIDENCE THAT CONNECTS PAYMENT TO HEALTHCARE CAPACITY
By examining the relationship between payer reimbursement, organizational stability, workforce capacity, and patient access, this study seeks to determine whether payer reimbursement disruption warrants consideration as a broader public health issue, and what interventions, if any, the evidence supports.