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Sector Focus

Interventional psychiatry: TMS and Spravato/esketamine.

The highest-margin service line in outpatient behavioral health, and the one where reimbursement and protocol risk are most often underwritten wrong.


Overview

Interventional psychiatry has become a standard value creation lever in outpatient behavioral health: an existing patient panel, a defined protocol, and contribution margins that outperform talk therapy per square foot. The models built on it are usually right about demand and wrong about sequencing.

Chair or device utilization ramps on credentialing and prior authorization timelines, not on marketing. Staffing has to cover monitoring requirements that do not flex with volume. Payer policy varies by state and plan, and a single medical policy change can reprice a site's economics inside a quarter.

We diligence those assumptions before close and build the service line after it.

What We Assess

  • Reimbursement structure. Payer mix and medical policy by state, contracted rates, authorization and re-authorization patterns, and denial exposure by code.
  • Protocol and compliance. Treatment protocol fidelity, monitoring requirements, REMS-compliant workflow for esketamine, and documentation standards.
  • Utilization economics. Device or chair utilization, session throughput, no-show and dropout behavior, and the ramp curve a new site actually achieves.
  • Staffing model. Prescriber coverage, monitoring staff, and the supervision structure the protocol requires.
  • Referral engine. Whether internal referral from an existing panel is real and durable or dependent on a small number of clinicians.

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Every engagement begins with a confidential conversation and a written scope. We typically respond within one business day.

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info@aluriaadvisory.com·LinkedIn·Jacksonville, Florida