We Made Inpatient Psychiatric Treatment Suck Less with this One Weird Trick

It is all about how care is paid for.

I know what you're thinking. Because I'm a psychiatrist, and we're psychic. That's a joke. Readers of this newsletter anxiously await the next regulatory issue, on which I will reliably advocate for compliance or public comment to regulators.

Today, the fans of “frontier-psychiatrists-brand public comment” are the winners. We have a real doozy on tap. You have the opportunity to make a big change. Psychiatric and general medical care in hospitals are paid for in completely different ways. In fact, there are two different payment models for psychiatric hospitals on the financial backend. Which contract the hospital has tells you a lot about the incentives they have to deploy novel treatments.

In every other medical condition, the payment model follows the same basic principles: you may get a hospital bill, and it's got a bunch of line items, and it's for a phenomenal amount of money, and then it gets knocked down to this or that. The mystery? This is not how any bills from Medicare…