Positioning Behavioral Health Services For Future Success. Howard Gershon Steven Mirin MD
|
|
|
- Darrell Maxwell
- 5 years ago
- Views:
Transcription
1 Positioning Behavioral Health Services For Future Success Howard Gershon Steven Mirin MD
2 Learning Objectives Determine the impact of regulatory and clinical advances on the future delivery of behavioral health services. Discover how successful organizations are developing innovative responses to these changes. 2
3 Agenda A Challenging Landscape Implications Provider Opportunities Critical Success Factors 3
4 Challenging Landscape Mental health affects One out of every 5 hospital stays 9.4 million stays (2008) 6 of every 10 stays paid by Medicare/Medicaid 1 of every 10 stays uninsured Average length of stay is greater 4
5 Organizational Challenges Negative revenue from inpatient & ambulatory lack of highly reimbursed procedures poor payer mix disposition and LOS problems low RVU-based productivity Maximizing revenue per square foot Physician coverage stretched to the limit 5
6 ACEP Study: Psychiatric patients in ED 79% of total respondents 90% board weekly 60% stay over 4 hours after decision to admit 62% did not provide psych services in ED 85% said ED wait times would improve with better psychiatric services 6
7 Other Challenges Workforce shortages Limited expertise among PCPs Lack of financial incentives Patients perceptions and fears create barriers Co-morbidities of mental health disorders with physical illness and substance abuse Racial and ethnic disparities Healthcare system structure restricts integration 7
8 Current System Not Working Behavioral health patients admitted to Medical & Surgical units Mentally ill boarded in ED Increase of mentally ill in jails/prisons 8
9 Our ability to deliver care in the same model that we have today is going to be very tightly constrained if not impossible. ~ C. Martin Harris, MD, MBA CIO Cleveland Clinic 9
10 Reform Passes 10
11 Will Reform Help? Bundled payment/acos Consider behavioral health aspect of healing/health Treating whole person, prevention and early intervention Medical homes Emphasis on prevention, early treatment Coordinated care Increase need to integrate with primary care Reimbursement More coverage under reform initiatives Medicaid paying for IP, OP and other supportive services Parity laws could improve coverage 11
12 There s no part of American life right now that is more in need of imagination and new ideas than Healthcare. Colin Powell 12
13 Foundation for Redesigned Service System Person Centered Integration Individual Control Quality 13
14 Opportunities for Providers Expand the Continuum Engage in Neurosciences Embrace Technology 14
15 Behavioral Health Continuum 15
16 Inpatient Opportunities Gero-psych PTSD Dual Diagnosis Women s Programs Consultation & Liaison Service 16
17 Outpatient Opportunities Medication Management Individual Therapy Groups ECT 17
18 Crisis Services Emergency Services 23 Hour Observation Mobile Services Crisis Residential Telephone Support 18
19 Opportunities Expand the Continuum Engage in Neurosciences Embrace Technology 19
20 Engage in Neurosciences 20
21 Integrated Neurosciences Cross departmental programs (i.e. psychiatry, neurology, neurosurgery) organized around disease-focused specialties or patient populations: Dementias TBI/stroke Psychiatric disorders (depression, OCD, others?) Epilepsy Parkinson s, other movement disorders Multi-disciplinary, cross-departmental collaborations in care delivery (clinical assessment, acute interventions, care management) Participants share space, staff and technology Cross disciplinary initiatives in clinical and translational research and teaching 21
22 Opportunities Expand the Continuum Engage in Neurosciences Embrace Technology 22
23 Electronic Medical Records 23
24 Telemedicine 24
25 Embrace Technology Imaging Procedural interventions ECT Deep Brain Stimulation Transcranial Magnetic Stimulation Pharmacogenomics 25
26 26
27 Characteristics of Successful Behavioral Health Systems 1. Continuum of care 2. Clinical services integration 3. Clinician organization integration 4. Primary care integration 5. Partnerships & affiliations 6. Market identity/image 7. Market development 27
28 Characteristics of Successful BHS Continuum of care Access to full continuum (beyond inpatient to include partial hospital, general and specialized ambulatory services, mobile crisis, ED and urgent care, ACT) No need to own them all. Some provided by community partners Key considerations include Consistency with organizational mission Organizational capabilities (clinical and administrative leadership, available time and resources) Anticipated financial performance 28
29 Characteristics of Successful BHS Clinical services integration Service line management structure that crosses departmental lines A unified model of care across practice sites and programs Inpatient and ambulatory integration including the ED Access to case management and other community services Focus on clinical process improvement patient-centered care Commitment to advancing quality and outcomes 29
30 Characteristics of Successful BHS Clinician organization integration Hospital- physician relationships come in many flavors- attending staff model, affiliated/contracted group practice, medical directorships, co management model, employed physicians As do strategies for aligning physician-hospital incentives joint contracting, pay for performance, risk sharing, gain sharing Key decisions include: Role of physicians and non-physicians in care delivery Physician deployment (across inpatient/ambulatory or in hospitalist model) Departmental vs. service line organization of care Role of physicians in site-specific, programmatic and system-level management 30
31 Characteristics of Successful BHS Primary care integration Co-location of behavioral health services and primary care inside the medical home Education and consultative support for primary care providers Behavioral health services integrated into routine care Easy access to generic and specialty behavioral health care outside the medical home when needed Protocols to guide referrals and clinical decision making Metrics to measure access to care, quality and clinical and financial outcomes 31
32 Characteristics of Successful BHS Partnerships & affiliations Hospitals/health systems cannot solve all of the behavioral health issues in their communities Partnerships with other organizations can include: Community Mental Health Organizations Clinician groups Residential providers County & state agencies Schools 32
33 Characteristics of Successful BHS Market identity/image Improve your market position and obtain more favorable contracts with payers and employers by: Improving customer service Providing centralized access Pursuing quality measures/ outcomes Developing other differentiators 33
34 Characteristics of Successful BHS Market development Continue to look for opportunities to expand markets and services. Expand geography through satellites Pursuing mergers/ acquisitions Contract management Assuming risk Developing niche programs 34
35 Behavioral Health Systems Benchmarks Continuum of Care (# services offered) Clinical Services Integration (# methods employed) Clinical Organization/Integration (# models in use) Primary Care Integration (# methods employed) Partnership & Affiliations (# partners) Market Identity/Image (# approaches employed) Market Development (# strategic initiatives) 35
36 We cannot solve the problems we have created with the same thinking that created them. Albert Einstein 36
37 Questions 37
38 Contact Steven Mirin, MD, Director Navigant Consulting Phone: navigantconsulting.com Howard Gershon, Principal New Heights Group, LLC Phone: reach-newheights.com 38
Population Health Management in the Safety Net Elaine Batchlor, MD, MPH CEO, Martin Luther King, Jr. Community Hospital
Population Health Management in the Safety Net Elaine Batchlor, MD, MPH CEO, Martin Luther King, Jr. Community Hospital November 5, 2013 Martin Luther King, Jr. Community Hospital Page 1 11/05/2013 Agenda
MAGELLAN UNIVERSAL SERVICES LIST - Includes Preferred HIPAA Compliant Codes. UB-04 Revenue Codes
Service Name & Detailed Magellan Description (see column heading explanations at end of this document) MAGELLAN UNIVERSAL SERVICES LIST - Includes Preferred HIPAA Compliant Codes Codes Used to Determine
Mental Health at Mercy Health: Treating the Whole Person. David E. Blair, MD Mercy Health Physician Partners President and CMO
Mental Health at Mercy Health: Treating the Whole Person David E. Blair, MD Mercy Health Physician Partners President and CMO Trinity Health s 22-state diversified system today $17.6B In Revenue 1.3M Attributed
Provider Orientation to Magellan s Outpatient Behavioral Health Model
Provider Orientation to Magellan s Outpatient Behavioral Health Model July 2017 Big-picture objectives Magellan Healthcare s outpatient care management model: Reduces provider administrative tasks Expedites
Robert N. Cuyler, Ph.D., Senior Associate, OPEN MINDS The 2014 OPEN MINDS Planning & Innovation Institute June 3, :15am 12:30pm
Robert N. Cuyler, Ph.D., Senior Associate, OPEN MINDS The 2014 OPEN MINDS Planning & Innovation Institute June 3, 2014 11:15am 12:30pm I. Overview Of The Current Telehealth Market II. Telehealth In An
WORK PROCESS DOCUMENT NAME: Medical Necessity Review for Behavioral Health and Substance Use Disorder REPLACES DOCUMENT: RETIRED:
PAGE: 1 of 7 SCOPE: Coordinated Care Departments for Behavioral Health and Substance Use Disorder (SUD) Reviews for members enrolled in Integrated Managed Care and Behavioral Health Services Only PURPOSE:
Behavioral Health Division JPS Health Network
Behavioral Health Division JPS Health Network Macro Trends 1 in 5 Adults in America experience a mental illness Diversion of Behavioral Health patients from jail Federal Prisons Mental Illness State Prison
Explaining the Value to Payers
Explaining the Value to Payers Explaining the Value to Payers This document has been created to provide talking points for EMS agencies to explain to payers the value of EMS 3.0 services. Please review
Evidence Based Practice: The benefits and challenges of behavioral health services in primary care settings.
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Evidence Based Practice: The benefits and challenges of behavioral health services in primary care settings.
How can we provide the same world class care to patients with psychiatric disorders? 11/27/2016. Dec 2016 Orlando, FL
The presenters have nothing to disclose Transforming Emergency Psychiatry Karen Murrell, MD, MBA, FACEP Physician Lead-Emergency Medicine, Kaiser Northern California Assistant Physician in Chief- Hospital
Follow-Up after Hospitalization for Mental Illness (FUH) Improvement Strategies
Follow-Up after Hospitalization for Mental Illness (FUH) Improvement Strategies 1. What efforts and/or strategies have you put in place to improve your plans performance on the Follow-Up After Hospitalization
A Brave New World: Lessons Learned From Healthcare Reform. Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage
A Brave New World: Lessons Learned From Healthcare Reform Brandy Shumaker, MBA, LPTA, LNHA Regional Vice President HealthPRO/Heritage 1 Learning Objectives Participants will understand: The impact health
The influx of newly insured Californians through
January 2016 Managing Cost of Care: Lessons from Successful Organizations Issue Brief The influx of newly insured Californians through the public exchange and Medicaid expansion has renewed efforts by
Value-Based Payments 101: Moving from Volume to Value in Behavioral Health Care
Value-Based Payments 101: Moving from Volume to Value in Behavioral Health Care Nina Marshall, MSW Senior Director, Policy and Practice Improvement NinaM@TheNationalCouncil.org Bill Hudock Senior Public
CHILDREN'S MENTAL HEALTH ACT
40 MINNESOTA STATUTES 2013 245.487 CHILDREN'S MENTAL HEALTH ACT 245.487 CITATION; DECLARATION OF POLICY; MISSION. Subdivision 1. Citation. Sections 245.487 to 245.4889 may be cited as the "Minnesota Comprehensive
OMC Strategic Plan Final Draft. Dear Community, Working together to provide excellence in health care.
Dear Community, Working together to provide excellence in health care. This mission statement, established nearly two decades ago, continues to be fulfilled by our employees and medical staff. This mission
4/22/2018. Redesign and Reimage Long Term Care for the Future. Health Care Landscape Change. Disclosure of Commercial Interests
Redesign and Reimage Long Term Care for the Future Lisa Thomson Chief Strategy and Marketing Officer www.pathwayhealth.com Disclosure of Commercial Interests We consult for the following organization:
Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy Annual Approval Date. Approved By
Policy Number 2016RP505A Facility-Based Behavioral Health Program Professional Fees Reimbursement Policy Annual Approval Date 09/30/2016 Approved By Optum Behavioral Reimbursement Committee IMPORTANT NOTE
Webinar 1-DLF Learning Collaborative. Liz Stallings, RN, BSN: Behavioral Health Consultant June 24, :30 PT
Webinar 1-DLF Learning Collaborative Liz Stallings, RN, BSN: Behavioral Health Consultant June 24, 2015 1-2:30 PT Introductions Liz Stallings RN, BSN Director Behavioral Health Services, HFS Consultants
2018 Annual Research Meeting (ARM) Conference Theme Areas of Focus
2018 Annual Research Meeting (ARM) Conference Theme Areas of Focus The 2018 ARM is organized around the following 21 themes in health services research and policy: AGING, DISABILITY, AND END-OF-LIFE This
Relationships: The Behavioral Health Consultant, Primary Care Physician, and Psychiatrist i t Healthcare Integration Webinar National Council for Community Behavioral Healthcare February 25, 2010 The Status
Medicaid and the. Bus Pass Problem
Medicaid and the Bus Pass Problem PRESENTED BY: Cardinal Innovations Healthcare Richard F. Topping, Chief Executive Officer Leesa Bain, Vice President, Care Coordination & Quality Management September
Partners in the Continuum of Care: Hospitals and Post-Acute Care Providers
Partners in the Continuum of Care: Hospitals and Post-Acute Care Providers Presented to the Wisconsin Association for Home Health Care November 3, 2017 By: Laura Rose WHA Vice President, Policy Development
Caring for the Underserved - Innovative Pharmacy Practice Integration
Caring for the Underserved - Innovative Pharmacy Practice Integration Sarah T. Melton, PharmD, BCPP, BCACP, FASCP Associate Professor Pharmacy Practice Clinical Pharmacist, Johnson City Community Health
Course Module Objectives
Course Module Objectives CM100-18: Scope of Services, Practice, and Education CM200-18: The Professional Case Manager Case Management History, Regulations and Practice Settings Case Management Scope of
Innovative and Outcome-Driven Practices and Systems Meaningful Prevention and Early Intervention Wellness, Recovery, & Resilience Focus
Our Mission: To provide a culturally competent system of care that promotes holistic recovery, optimum health, and resiliency. Our Vision: We envision a community where persons from diverse backgrounds
ACADEMIC GROUP PRACTICE AND THE LEADERSHIP OF APRN S
ACADEMIC GROUP PRACTICE AND THE LEADERSHIP OF APRN S Margaret Head, Chief Operating Officer/Chief Nursing Officer Susan Moseley Gent, Administrative Director Vanderbilt Medical Group March 10, 2012 With
Implementing Medicaid Behavioral Health Reform in New York
Redesign Medicaid in New York State Implementing Medicaid Behavioral Health Reform in New York Conference of Local Mental Hygiene Directors November 19, 2013 Agenda Goals Timeline BH Benefit Design Overview
Innovative Business Activities in Health Care with Commercial Partners
Innovative Business Activities in Health Care with Commercial Partners Steve Witman, CPA, MBA Vice President of Business Development / Financial and Capital Planning LifeBridge Health March 4, 2014 Business
Managing Utilization Review in Light of Parity (MHPAEA)
Managing Utilization Review in Light of Parity (MHPAEA) The Healthcare Association of New York State Conference SAE & Associates Parity Compliance Team October 4, 2017 SAE & Associates Parity Compliance
Creating a Data-Driven Culture to Right-Size Capacity and Enhance Quality and Safety
Creating a Data-Driven Culture to Right-Size Capacity and Enhance Quality and Safety MaryPat Sullivan, CNO and Chief Experience Officer, Overlook Medical Center, Atlantic Health System, Summit, NJ Jacalyn
Optum/OptumHealth Behavioral Solutions of California Facility Network Request Form / Credentialing Application
Optum/OptumHealth Behavioral Solutions of California Is the facility currently in the Optum network? Yes No Acceptance into the Optum/OptumHealth Behavioral Solutions of California (Optum) provider network
Clinical Service Lines: Mapping the Future of Community Health
Clinical Service Lines: Mapping the Future of Community Health By Daniel K. Zismer, Ph.D. and Donald C. Wegmiller, MHA, FACHE About this report While accountable care, health reform and meaningful use
Transitioning to a Value-Based Accountable Health System Preparing for the New Business Model. The New Accountable Care Business Model
Transitioning to a Value-Based Accountable Health System Preparing for the New Business Model Michael C. Tobin, D.O., M.B.A. Interim Chief medical Officer Health Networks February 12, 2011 2011 North Iowa
Paula Stone Deputy Director, DMS, DHS
Paula Stone Deputy Director, DMS, DHS 1 Outpatient mental health services available to AR Medicaid beneficiaries include: Individual, family and group counseling services provided in an outpatient agency
ACOs the Medicare Shared Savings Program And Other Healthcare Reform Payment Methods
A unique vision for an ever-changing healthcare environment ACOs the Medicare Shared Savings Program And Other Healthcare Reform Payment Methods Presented by Joe Laden, President, ORVA, LLC The Environment
6/27/2014. THE NEW TECHNOLOGY LANDSCAPE Presentation Objectives. The Landscape Drives Metrics. Issues: Responding to Need. AZ Drivers/Priorities
x == 6/27/2014 THE NEW TECHNOLOGY LANDSCAPE Presentation Objectives Using Business Analytics & Health Information Exchanges to Improve Practice & Sustain Organizations Business Metric Development Strategies
Challenges in Faculty Compensation
Challenges in Faculty Compensation José Biller, MD, FACP, FAAN, FANA, FAHA Professor and Chairman Department of Neurology Loyola University Chicago Stritch School of Medicine Michael Budzynski Executive
Connected Care Partners
Connected Care Partners Our Discussion Today Introducing the Connected Care Partners CIN What is a Clinically Integrated Network (CIN) and why is the time right to join the Connected Care Partners CIN?
Physician Alignment Strategies and Options. June 1, 2011
Physician Alignment Strategies and Options June 1, 2011 1 Today s Discussion Review physician-hospital alignment objectives Understand the changing paradigm Evaluate alignment strategies for a new delivery
Troubleshooting Audio
Welcome! Audio for this event is available via ReadyTalk Internet streaming. No telephone line is required. Computer speakers or headphones are necessary to listen to streaming audio. Limited dial-in lines
Behavioral Health Provider Training: Program Overview & Helpful Information
Behavioral Health Provider Training: Program Overview & Helpful Information Overview The Passport Behavioral Health Program provides members with access to a full continuum of recovery and resiliency focused
Behavioral Health Provider Training: Program Overview & Helpful Information
Behavioral Health Provider Training: Program Overview & Helpful Information Overview The Passport Behavioral Health Program provides members with access to a full continuum of recovery and resiliency focused
I. Coordinating Quality Strategies Across Managed Care Plans
Jennifer Kent Director California Department of Health Care Services 1501 Capitol Avenue Sacramento, CA 95814 SUBJECT: California Department of Health Care Services Medi-Cal Managed Care Quality Strategy
Acute Crisis Units. Shelly Rhodes, Provider Relations Manager
Acute Crisis Units Shelly Rhodes, Provider Relations Manager Shelly.Rhodes@beaconhealthoptions.com Training Agenda Agenda: Transition and Certification Coverage of Services Service Code Definition Documentation
Hospital Urgent Care Operations: A Pathway to Profitability
Hospital Urgent Care Operations: A Pathway to Profitability Alan A. Ayers, MBA, MAcc Chief Executive Officer, Velocity Urgent Care Vice President of Strategic Initiatives, Practice Velocity, LLC Practice
Ensuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment
Ensuring Your Surgical Service Line is Successful in an ACO Value-Based Purchasing and Bundled Payment Environment Jeffry Peters, President Surgical Directions, LLC Joseph Bosco, MD Associate Professor;
North Carolina s Transformation to Managed Care
North Carolina s Transformation to Managed Care Jay Ludlam, Assistant Secretary Department of Health and Human Services December 2017 My background Only 10+ years of experience in Medicaid Assistant Attorney
Building a Stronger Work Marriage
PROVIDER ENGAGEMENT Building a Stronger Work Marriage Lessons in Dyad Leadership Karim Botros MetroHealth Matt Garabrant The Advisory Board Company Fred Neis The Advisory Board Company Road Map 2 1 2 MetroHealth
STROKE REHAB PROGRAM
STROKE REHAB PROGRAM Allied Rehab Hospital is part of Allied Services Integrated Health System, the premier post-acute health-care system in Northeast Pennsylvania, and is the region s leading provider
Anthem Blue Cross Cal MediConnect Plan (Medicare- Medicaid Plan) Santa Clara County Behavioral Health provider training
Anthem Blue Cross Cal MediConnect Plan (Medicare- Medicaid Plan) Santa Clara County Behavioral Health provider training Anthem Blue Cross Cal MediConnect Plan Effective January 1, 2015, Anthem Blue Cross
Specialty Behavioral Health and Integrated Services
Introduction Behavioral health services that are provided within primary care clinics are important to meeting our members needs. Health Share of Oregon supports the integration of behavioral health and
TO MEMBERS OF THE COMMITTEE ON GROUNDS AND BUILDINGS: 1 DISCUSSION ITEM UPDATE ON UC SAN DIEGO HEALTH SYSTEM STRATEGIC PLAN, SAN DIEGO CAMPUS
GB3 Office of the President TO MEMBERS OF THE COMMITTEE ON : 1 For Meeting of DISCUSSION ITEM UPDATE ON UC SAN DIEGO HEALTH SYSTEM STRATEGIC PLAN, SAN DIEGO CAMPUS EXECUTIVE SUMMARY As a comprehensive
INTEGRATION AND COORDINATION OF BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE
THE CENTER FOR POLICY, ADVOCACY, AND EDUCATION OF THE MENTAL HEALTH ASSOCIATION OF NEW YORK CITY INTEGRATION AND COORDINATION OF BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE A Presentation at The Community
Advanced Illness Management Leveraging Person Centered Care and Reengineering the Care Team Across the Continuum
Advanced Illness Management Leveraging Person Centered Care and Reengineering the Care Team Across the Continuum Betsy Gornet, FACHE Chief Advanced Illness Management Executive Sutter Health / Sutter Care
Overview of Alaska s Hospitals and Nursing Homes. House HSS Committee March 1, 2012
Overview of Alaska s Hospitals and Nursing Homes House HSS Committee March 1, 2012 Alaska Hospital and Nursing Homes Testifying Today Fairbanks Memorial Hospital Mike Powers Central Peninsula Hospital
Community Forum for Proposed
Community Forum for Proposed OMC / Swedish Affiliation Presented By: August 3, 2011 Eric Lewis Chief Executive Officer, Olympic Medical Center Marcel Loh Marcel Loh Chief Administrative Officer, Swedish
This report is a summary of the November 2015 Behavioral Health Stakeholder s Summit that was held in Fargo.
This report is a summary of the November 2015 Behavioral Health Stakeholder s Summit that was held in Fargo. February 10, 2016 ADULT BEHAVIORAL HEALTH November 2015 Summary Report Exchange of information
L8: Care Management for Complex Patients: Strategies, Tools and Outcomes
The Triple Aim 16 th Annual Summit: Institutes for Healthcare Improvement - Improving Patient Care in the Office Practice and the Community March 16, 2015 Dallas, Texas L8: Care Management for Complex
JULY 2012 RE-IMAGINING CARE DELIVERY: PUSHING THE BOUNDARIES OF THE HOSPITALIST MODEL IN THE INPATIENT SETTING
JULY 2012 RE-IMAGINING CARE DELIVERY: PUSHING THE BOUNDARIES OF THE HOSPITALIST MODEL IN THE INPATIENT SETTING About The Chartis Group The Chartis Group is an advisory services firm that provides management
Mental Health Board Member Orientation & Training
1 Mental Health Board Member Orientation & Training See Tab 1 Mental Health Timeline 1957 Sources: California Legislative Analyst Office & California Department of Health Care Services to Prior to 1957
2014 Review of Habilitative and Mental/Behavioral Health and Substance Abuse Services
2014 Review of Habilitative and Mental/Behavioral Health and Substance Abuse Services Please note that a similar version of this summary was distributed on 9/13/2013 but did not include attachments. Please
Covered Behavioral Health Services
Behavioral Health Services Covered Behavioral Health Services Cenpatico, Buckeye s behavioral health affiliate, has been delegated the provision of covered mental health and substance use disorder services
Targeting Readmissions:
Targeting Readmissions: A Collaborative Strategy for Hospitals, Health Plans and Local Communities Speaker: Gina Lasky, PhD, Senior Consultant, Warren Lyons, Principal, Suzanne Mitchell, MD, Principal,
Behavioral Health Services in Ohio Hospitals Ohio Hospital Association. Ohio Department of Medicaid January 23, 2018
Behavioral Health Services in Ohio Hospitals Ohio Hospital Association Ohio Department of Medicaid January 23, 2018 1 Outpatient Hospital Behavioral Health Services 2 OPHBH Services in Hospitals Outpatient
TEXAS HEALTHCARE TRANSFORMATION & QUALITY IMPROVEMENT PROGRAM. Bluebonnet Trails Community Services
TEXAS HEALTHCARE TRANSFORMATION & QUALITY IMPROVEMENT PROGRAM Regional Healthcare Partnership Region 4 Bluebonnet Trails Community Services Delivery System Reform Incentive Payment (DSRIP) Projects Category
Primary Care 101: A Glossary for Prevention Practitioners
PREVENTION COLLABORATION IN ACTION Engaging the Right Partners Primary Care 101: A Glossary for Prevention Practitioners As the U.S. healthcare landscape continues to change under the Affordable Care Act
TELEHEALTH INDEX: 2015 PHYSICIAN SURVEY
TELEHEALTH INDEX: 2015 PHYSICIAN SURVEY Overview Telehealth is accelerating in 2015. As many as 37% of hospital systems have at least one type of telemedicine solution to meet a variety of objectives,
Navigating New York State s Transition to Managed Care
Navigating New York State s Transition to Managed Care December 3, 2014 Mary McKernan McKay, Ph.D Andrew F. Cleek, Psy.D. Meaghan E. Baier, LMSW Agenda Introduction of the Managed Care Technical Assistance
Value-Based Care Contracting and Legal Issues
Session 4b Value-Based Care Contracting and Legal Issues Presented by: Janet Walker Farrer General Counsel and Insurance Legal Department Chair Ascension Health Leah Stewart Associate Vice President for
Bristol CCG North Somerset CGG South Gloucestershire CCG. Draft Commissioning Intentions for 2017/2018 and 2018/2019
Bristol CCG North Somerset CGG South Gloucestershire CCG Draft Commissioning Intentions for 2017/2018 and 2018/2019 Programme Area Key intention Primary and community care Sustainable primary care Implement
Alternative Managed Care Reimbursement Models
Alternative Managed Care Reimbursement Models David R. Swann, MA, LCSA, CCS, LPC, NCC Senior Healthcare Integration Consultant MTM Services Healthcare Reform Trends in 2015 Moving from carve out Medicaid
Mental Health Liaison Group
Mental Health Liaison Group The Honorable Nancy Pelosi The Honorable Harry Reid Speaker Majority Leader United States House of Representatives United States Senate Washington, DC 20515 Washington, DC 20510
Transforming Healthcare Delivery, the Challenges for Behavioral Health
Transforming Healthcare Delivery, the Challenges for Behavioral Health Presented by: M.T.M. Services, LLC P. O. Box 1027, Holly Springs, NC 27540 Phone: 919-434-3709 Fax: 919-773-8141 E-mail: mtmserve@aol.com
Understanding the Implications of Total Cost of Care in the Maryland Market
Understanding the Implications of Total Cost of Care in the Maryland Market January 29, 2016 Joshua Campbell Director KPMG LLP Matthew Beitman Sr. Associate KPMG LLP The concept of total cost of care is
Community Mental Health and Care integration. Zandrea Ware and Ricardo Fraga
Community Mental Health and Care integration Zandrea Ware and Ricardo Fraga One in Five Approximately 1 in 5 adults in the U.S. 43.8 million, or 18.5% experiences mental illness in their lifetime. Community
Implementing Medicaid Behavioral Health Reform in New York
Redesign Medicaid in New York State Implementing Medicaid Behavioral Health Reform in New York HIV Health and Human Services Planning Council of New York March 19, 2014 Agenda Goals Timeline BH Benefit
Thought Leadership Series White Paper The Journey to Population Health and Risk
AMGA Consulting Thought Leadership Series White Paper The Journey to Population Health and Risk The Journey to Population Health and Risk Howard B. Graman, M.D., FACP White Paper, January 2016 While the
Integration Improves the Odds: Lessons Learned. Monday, December 18 th, 2017
Integration Improves the Odds: Lessons Learned Monday, December 18 th, 2017 Julie Cornell, North America Regional Manager, Global Community Impact INTEGRATION IMPROVES THE ODDS Lessons Learned Webinar
MEDICAID ACCELERATED EXCHANGE (MAX) SERIES ACCELERATE TRANSFORMATION AND LASTING CHANGE
MEDICAID ACCELERATED EXCHANGE (MAX) SERIES ACCELERATE TRANSFORMATION AND LASTING CHANGE Presented by: Linda Efferen, MD, MBA Medical Director Suffolk Care Collaborative 19 THE MAX SERIES SUPPORTS AN INTERDISCIPLINARY
MBHP Massachusetts Emergency Services Program Overview Presentation. August 2016
MBHP Massachusetts Emergency Services Program Overview Presentation August 2016 Emergency Services Program (ESP) Mission and Purpose The Mission of ESP is to: Deliver high-quality, culturally competent,
Understanding the Initiative Landscape in Medi-Cal. IHA Stakeholder Meeting September 23, 2016 Sarah Lally, Project Manager
Understanding the Initiative Landscape in Medi-Cal IHA Stakeholder Meeting September 23, 2016 Sarah Lally, Project Manager Agenda Welcome / Introduction Sarah Lally, Project Manager Inland Empire Health
Recovery Homes: Recovery and Health Homes under Health Care Reform
Recovery Homes: Recovery and Health Homes under Health Care Reform 4/27/11 Richard H. Dougherty, Ph.D. DMA Health Strategies Challenges of health reform Increasing coverage Reducing costs of coverage Reducing
The National ACO, Bundled Payment and MACRA Summit. Success in Physician Led Bundles
The National ACO, Bundled Payment and MACRA Summit Success in Physician Led Bundles Disclaimer This material and/or presentation is provided for guidance and/or illustrative purposes only and should not
Primary Care/Behavioral Health INTEGRATION. Neal Adams, MD MPH Deputy Director California Institute for Mental Health
Primary Care/Behavioral Health INTEGRATION Neal Adams, MD MPH Deputy Director California Institute for Mental Health Why Integrate BH & PC? BH disorder burden is great BH and physical health problems are
Improving Outcome and Efficiency with. Service Delivery
Transforming Public Behavioral Health Care: Improving Outcome and Efficiency with Consumer-Driven, Outcome-Informed (CDOI) Service Delivery Scott D. Miller, Ph.D. http://twitter.com/scott_dm http://www.linkedin.com/in/scottdmphd
Managed care consulting services
Managed care consulting services WeiserMazars Health Care Consulting Services WeiserMazars LLP is an independent member firm of Mazars Group. WeiserMazars Health Care Group Managed Care consulting services
2017 Quality Improvement Work Plan Summary
Project Member Service and Satisfaction Commercial Products: Commercial Project Description: To improve member service and satisfaction and increase member understanding of how the member s plan works.
MBHP FISCAL YEAR 2015 PROVIDER RATE INCREASES AND INCENTIVES
ALERT # 149 September 9, 2014 MBHP FISCAL YEAR 2015 PROVIDER RATE INCREASES AND INCENTIVES The following information should be noted immediately by your chief executive officer, chief medical officer,
MANAGED CARE CONSULTING SERVICES
CONSULTING SERVICES WeiserMazars Health Care Consulting Services THE NEW JERSEY HOSPITAL ASSOCIATION April 30,2013 WeiserMazars LLP is an independent member firm of Mazars Group. WEISERMAZARS HEALTH CARE
ARRA New Opportunities for Community Mental Health
ARRA New Opportunities for Community Mental Health Presented to: The Indiana Council of Community Behavioral Health Kevin Scalia Executive Vice-President, Corporate Development February 11, 2010 Overview
Value-Based Care Emergent Care Services. Presented by Cliff Frank Partnera Partners LLC
Value-Based Care Emergent Care Services Presented by Cliff Frank Partnera Partners LLC Problem Un-doctored consumers are driving $575 billion inappropriate emergent care Fee-for-service ER visits add another
Strategies for Neuroscience Program Regionalization
Technology Insights Strategies for Neuroscience Program Regionalization Original Inquiry Brief August 7, 2013 Research in Brief As neuroscience programs look to grow volumes, capture larger market share,
Acute Psychiatry Solutions
Acute Psychiatry Solutions Expert care when patients need it most We believe psychiatric emergencies are medical emergencies. We also believe the best psychiatric care is delivered when patients are treated
Objectives. Models of Integrated Behavioral Health Care 9/23/2015
Models of Integrated Behavioral Health Care Carlton D. Craig, Ph.D. Vernon R. Wiehe Endowed Professor in Family Violence University of Kentucky College of Social Work Carlton.craig@uky.edu (859)-257-6657
Major Dimensions of Managed Behavioral Health Care Arrangements Level 3: MCO/BHO and Provider Contract
Introduction To understand how managed care operates in a state or locality it may be necessary to collect organizational, financial and clinical management information at multiple levels. For instance,
Patient Navigator Program
Using Patient Navigators and Education to Improve Post-Acute Transitions Emerging innovators in post-acute care delivery models are finding ways to provide patient-centered, quality care to integrate today
Outpatient Hospital Facilities
Outpatient Hospital Facilities Chapter 6 Chapter Outline Introduce students to 1. Different outpatient facilities 2. Different departments involved in the reimbursement process 3. The Chargemaster 4. Terminology
Joining Passport Health Plan. Welcome IMPACT Plus Providers
Joining Passport Health Plan Welcome IMPACT Plus Providers Agenda Passport Behavioral Health Services Overview Steps to Joining Passport Health Plan s Network Getting a Medicaid Number Enrolling in the
Three C s of Change in the Value-Based Economy: Competency, Culture and Compensation. April 4, :45 5:00 pm
Three C s of Change in the Value-Based Economy: Competency, Culture and Compensation April 4, 2014 3:45 5:00 pm 1 Introduction Kevin McCune, MD Chief Medical Officer Advocate Medical Group Peg Stone Vice