1. Insurance Reimbursement Complications

Spravato treatments are expensive, and most patients rely on insurance coverage to afford them. However, the reimbursement process is often cumbersome and requires thorough documentation, pre-authorization, and ongoing justification for treatment continuation.

• Challenge: Practices may underestimate the time and resources needed to manage insurance claims.
• Solution: Employ dedicated billing specialists who understand the nuances of Spravato claims. Partnering with experienced third-party billing services can also help navigate this maze.

2. Insufficient Patient Volume

For a Spravato practice to be financially sustainable, a steady stream of eligible patients is critical. However, many practices struggle with low patient volume due to inadequate marketing or lack of
referrals.

• Challenge: Failing to educate potential patients and referring providers about Spravato’s benefits.
• Solution: Invest in targeted marketing strategies, such as educational outreach to primary care providers and psychiatrists. Optimize your online presence with SEO to attract self-referring patients searching for TRD solutions.

3. Staffing and Training Issues

Administering Spravato requires a dedicated team trained in its use, including the administration process, patient monitoring, and safety protocols. Practices often underestimate the time and effort required to train staff and keep them engaged.

• Challenge: High staff turnover or burnout due to unclear roles and expectations.
• Solution: Provide comprehensive training and clearly define staff roles. Ensuring adequate staffing levels can help prevent burnout while fostering a supportive team environment.

4. Regulatory and Safety Compliance

Spravato must be administered under strict guidelines, including its classification as a REMS (Risk Evaluation and Mitigation Strategy) drug. Practices that fail to adhere to these regulations risk non-compliance, which can lead to significant consequences.

• Challenge: Keeping up with REMS compliance and safety protocols can be daunting.
• Solution: Assign a compliance officer or delegate a staff member to oversee adherence to REMS requirements. Regularly review and update protocols to ensure they meet the latest guidelines.

5. Misaligned Financial Expectations

Many practitioners start a Spravato practice with the hope of significant financial returns, only to find the revenue streams inconsistent due to delayed reimbursements and high operational costs.

• Challenge: Practices fail to properly forecast cash flow and profitability.
• Solution: Develop a robust financial plan that accounts for initial investment, reimbursement delays, and ongoing costs. Diversify services to supplement income during the practice’s growth phase.

6. Lack of Patient Support and Follow-Up

Spravato isn’t a one-and-done treatment; it requires a series of sessions and ongoing monitoring. Practices that fail to provide proper follow-up and patient education risk losing patients before achieving optimal outcomes.

• Challenge: Patients drop out due to lack of support or unclear treatment plans.
• Solution: Establish a patient support system that includes regular check-ins, clear communication about the treatment process, and addressing patient concerns proactively.