Behavioral Health & Substance Use Disorder (SUD) MSO Consolidation
Transition legacy facilities from volatile out-of-network billing to stable in-network commercial contracts, build multi-facility ASAM continuum-of-care networks, and capture 12x+ EBITDA multiples.
Behavioral health and substance use disorder (SUD) treatment platforms have evolved from high-risk out-of-network models into institutional, clinically validated private equity consolidations. Success requires managing complex ASAM (American Society of Addiction Medicine) levels of care: from medical detox (ASAM 3.7) and residential inpatient (ASAM 3.5) to partial hospitalization (PHP 2.5), intensive outpatient (IOP 2.1), and outpatient psychotherapy. Kompanie LLP guides PE sponsors in executing behavioral health roll-ups: navigating state licensing boards, securing joint commission (JCAHO/CARF) accreditations, and structuring compliant Friendly-PC clinical governance models.
Deliverables
- Friendly-PC corporate governance architecture compliant with state Medical and Psychological Board regulations.
- Strategic out-of-network (OON) to in-network (INN) commercial payer contract renegotiation playbooks.
- ASAM clinical level-of-care step-down protocols maximizing patient length of stay and outcomes.
- EKRA (Eliminating Kickbacks in Recovery Act, 18 U.S.C. § 220) lab testing and marketer commission compliance audits.
Frequently asked questions
How does EKRA affect behavioral health and addiction treatment acquisitions?
EKRA criminalizes paying commissions to marketers, recruiters, or laboratories based on patient volume or test revenue, regardless of whether commercial insurance or Medicare is billed. We perform rigorous EKRA compensation scrubbing during pre-acquisition due diligence.
Why are institutional investors transitioning behavioral health centers in-network?
While out-of-network centers initially capture high per-diem rates, commercial payers subject them to aggressive Special Investigation Unit (SIU) audits and payment freezes. In-network contracts provide sustainable, predictable EBITDA that institutional lenders and secondary buyers demand.