BEHAVIORAL HEALTH HOMES Rhode Island and Missouri Models
|
|
- Mark Evans
- 5 years ago
- Views:
Transcription
1 BEHAVIORAL HEALTH HOMES Rhode Island and Missouri Models CT Behavioral Health Partnership Oversight Council Adult Quality, Access and Policy Committee BHH Workgroup October 17, 2012
2 Agenda Rhode Island BHH Model Missouri BHH Model Comparison of Models Next Steps
3 Rhode Island BHH Model Representatives from DMHAS and DSS met with officials from RI s Department of Behavioral Healthcare, Development Disabilities and Hospitals in September 2012 to gather information and garner lessons learned on their BHH model
4 Rhode Island Behavioral Health Home (BHH) Model 9 state designated private non-profit Community Mental Health Organizations (CMHOs) operating statewide Serve adults diagnosed with Severe and Persistent Mental Illness (SPMI) Approximately 5000 Medicaid clients eligible About 1/3 of CMHO BHH consumers have both Medicare and Medicaid (not included in RI s MME Proposal) 2 sites have SAMHSA Primary Care Integration Grants
5 Why Did RI Develop Behavioral Health Homes? SPMI have complex medical, behavioral health and psychosocial needs Built upon CMHO infrastructure already in place Harness unique capabilities of CMHOs boots on the ground Used 90% match to absorb $13M cut to BH services
6 Attribution to BHHs Universal eligibility criteria no enrollment process Individuals receiving services from a CMHO who meet the HH criteria are deemed HH clients No opt-out, but clients can choose to stop receiving services from CMHO
7 BHH Team Each team must have a caseload of at least 200 Each team is comprised of a multi-disciplinary group of professionals and peers (11.25 FTEs) which include: Master s Team Coordinator 1FTE Psychiatrist -.5 FTE Registered Nurse 2.5 FTE MA Level Clinician.5 FTE Community Psychiatric Supportive and Treatment Specialist (CPST) 5.5 FTE CPST Specialist Hospital Liaison 1FTE Peer Specialist -.25 FTE (phased in as resources available)
8 BHH Team Roles Health Home Service Care Management Primary Team Member Master s Level Team Coordinator Primary Care Coordination CPST Specialist Health Promotion Nurses and Psychiatrist Transitional Care CPST Hospital Liaisons Family Psycho-education CPST Specialists Referral to Community and Social Support Services CPST Specialists
9 Goals for RI BHH 1. Improve Care Coordination 2. Reduce Preventable ED visits 3. Increase Use of Preventative Services 4. Improve Management of Chronic Conditions 5. Improve Transitions to CMHO Services 6. Reduce Hospital Admissions
10 Data Reporting There is no standardized assessment, but CMHOs are responsible to report data to the state on HH outcome measures Outcome data is collected by BHHs and the state and combined within an aggregate outcome reporting spreadsheet Outcomes are based on a combination of claims data and chart audits Providers report encounter data in 5 minute increments The state originally posited 15 minute increments but Providers voiced concern about losing credit
11 Data Sharing MCOs give admission data to CMHOs within 2 days of hospital admit as the MCOs preauthorize the hospital stay MCOs give other medical data to CMHOs on a quarterly basis
12 Financing BHH services paid on a Per Member Per Month (PMPM) basis There were no start up payments and are no performance incentive payments CMHOs bill for 1 code for all health home activities and use FFS codes for all other Medicaid covered services Some FFS codes were transitioned to the all inclusive HH code In order to bill, BHHs must provide: at least 1 hour of service per month At least 1 hour of face to face per quarter At least 3 hours of service per month in aggregate for all clients
13 Lessons Learned Build upon existing infrastructure Be data informed RI implemented BHHs to avoid budget cuts (by securing 90% match) needed to be cost neutral RI overestimated the number of individuals that were eligible for BHHs (CMHOs) RI did not account for individuals on spend down Long-term cost neutrality or savings may not be guaranteed is case load growth occurs Medicare data is needed and is hard to secure
14 Lessons Learned Cost savings May not be realized in the sort-term but believe that the BHH model will improve care for clients Accountability Increased accountability for both state and providers CMHOs meeting new requirements Tracking and documenting HH activities Data/Outcomes Management CMS outcome measures difficult to track Build/purchase technology up front to manage and report data
15 Agenda Rhode Island BHH Model Missouri BHH Model Comparison of Models Next Steps
16 Missouri BHH Model Representatives from DMHAS and DSS held a teleconference with the Medical Director, Joe Parks, MD, from Missouri s Department of Mental Health in January 2012 to gather information and garner lessons learned from their BHH model which was the first one approved and implemented across the nation
17 Missouri BHH Model 28 State designated private non-profit Community Mental Health Centers (CMHCs) operating statewide (and affiliates) Serve adults and children diagnosed with MH+ another chronic condition or SUD+ another chronic condition Very few children fall into population based on data Population limited by severity (cost threshold established) MMEs included in population (MO s MME proposal is to use the existing HH model)
18 Why did MO Develop Behavioral Health Homes It was the next natural step: Build upon existing infrastructure (CMHC Psychiatric Rehabilitative Teams) Build upon existing integration initiatives (CMHC/FQHC collaborations) Increase wellness and prevention Would have to face additional reductions without implementation (assumed $7.8M in savings)
19 Attribution to BHHs Individuals who meet the cost threshold are auto-enrolled to the CMHC based on current source of care Individuals can choose to receive care elsewhere or can opt-out completely
20 BHH Team Health Home Director 1 FTE Nurse Care Manager 1 FTE per 250 Admin Support 1 FTE per 500 Physician Consultation 1 hour per enrollee per year Psychiatric Rehabilitation Team Members (funded separately): Psychiatrist, Behavioral Health Clinician, Community Support Specialist)
21 BHH Team Roles Health Home Service Care Management Primary Team Member Nurse Care Manager, HH Director Care Coordination Nurse Care Manager with assistance from Admin Support Health Promotion Nurse Care Manager, HH Director, Physician Consult Transitional Care Nurse Care Manager, HH Director, Physician Consult Family Psycho-education Nurse Care Manager Referral to Community and Social Support Services Nurse Care Manager with assistance from Admin Support
22 Goals for MO BHH Implement and evaluate the Health Home model as a way to achieve accessible, high quality primary health care and behavioral health care Demonstrate cost-effectiveness in order to justify and support the sustainability and spread of the model Support primary care and behavioral care practice sites by increasing available resources and improving care coordination to result in improved quality of clinician work life and patient outcomes.
23 Data Management and Analytics Uses 2 different contractors One manages EHR off of Medicaid claims The other manages data analytics: care management technologies, aggregate/benchmarking reporting, to-do lists, etc. Notification of Hospital Admit from Missouri Health Net (MHN) concurrent authorization system Care Coordination via CyberAccess Medication Adherence reports
24 Technological Tools CyberAccess: Web-based electronic health record (EHR) accessible to enrolled Medicaid providers, including CMHCs Direct Inform as EHR patient portal: A module of the MHN comprehensive, web-based EHR allows enrollees to look up their own healthcare utilization and receive the same content in laypersons terms The information facilitates self-management and monitoring necessary for an enrollee to attain the highest levels of health and functioning
25 Financing BHH services paid on a per member per month basis Providers are required to pay a small PMPM ($2-3) to vendors for data management, training, technical and administrative support Start up payments made to cover infrastructure costs: recruiting, training, IT changes, etc. MO may pursue incentive payments in the future based on shared savings and performance
26 Lessons Learned Build upon existing infrastructure Be data informed Data analytics should come first before defining population and providers Training via statewide learning collaboratives - just as important as data analytics Multiple data contractors creates productive competition
27 Agenda Rhode Island BHH Model Missouri BHH Model Comparison of Models Next Steps
28 Attribution Rhode Island Auto assignment based on current CMHO provider No opt out but may choose to stop receiving services or choose another provider Missouri Auto enrolled based on current CMHC provider May opt out or choose another provider
29 BHH Team Rhode Island The team will vary according to unique needs of individuals but will minimally consists of a Master s team coordinator who will serve as the central coordinator of health home services, psychiatrist, registered nurse, MA level clinician, CPST Specialist/hospital liaison, CPST Specialist and Peer Specialist Missouri Physician-led with health team of a health home director, a health home primary care physician consultant, nurse care manager(s) and health home administrative support staff Other team members may include: primary care physicians, pharmacists, substance abuse specialists, vocational and community integration specialists Optional staff include an individual s treating physician and psychiatrist, mental health case manager, nutritionist/dietician, pharmacist, peer recovery specialist CMHOs will participate in statewide learning activities to promote practice transformation CMHCs will be supported in statewide learning activities to promote practice transformation CMHOs as designated providers CMHCs as designated providers
30 Data Management Rhode Island Missouri No interoperable EHR Data collected and reported by both the state and BHHs via multiple methods MCOs provide admission information to BHHs Well developed web-based interoperable EHR information available to providers and members Extensive data analytics and information sharing Contracted with 2 data management vendors
31 Financing Rhode Island Missouri Monthly PMPM to BHH Monthly PMPM to BHH No start up or incentive payments Part of PMPM used for administrative costs of data vendors and learning collaboratives Infrastructure payments made and exploring incentive payments
32 Agenda Rhode Island BHH Model Missouri BHH Model Comparison of Models Next Steps
33 Next Steps State Partners Data Financial Model HIT BHH Workgroup Care Team Composition Provider Infrastructure Provider Credentials Outcome Measures
CMHC Healthcare Homes. The Natural Next Step
CMHC Healthcare Homes The Natural Next Step Partners in Planning A collaborative effort involving Dept. of Social Services (Mo HealthNet) Dept. of Mental Health Primary Care Association (FQHCs) Coalition
More informationImplementing 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
More informationImplementing 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
More informationOPERATIONAL PROTOCOLS FOR COLLABORATION BETWEEN HEALTH PLANS AND HEALTH HOMES
OPERATIONAL PROTOCOLS FOR COLLABORATION BETWEEN HEALTH PLANS AND HEALTH HOMES Introduction The Contractor s Agreement with the Executive Office of Health and Human Services (EOHHS) states that Contractor
More informationPaving the Way for. Health Homes
Paving the Way for Health Homes Paving the Way for Healthcare Homes Affordable Care Act The Affordable Care Act passed by Congress and signed into law by the president in March 2010, provides a variety
More informationUPDATE ON MANAGED CARE IN NY STATE: IMPLICATIONS FOR PROVIDERS
UPDATE ON MANAGED CARE IN NY STATE: IMPLICATIONS FOR PROVIDERS November 18, 2013 NYS OMH Behavioral Health Transition 2 Key MRT initiative to move fee-for-service populations and services into managed
More informationAdult Behavioral Health Home and Community Based Services Quality and Infrastructure Program: Improving Lives
Adult Behavioral Health Home and Community Based Services Quality and Infrastructure Program: Improving Lives April 30, 2018 2 Agenda for the Day Vision and Overview: HARP and BH HCBS Recovery Coordination
More informationHealth Home State Plan Amendment
Health Home State Plan Amendment OMB Control Number: 0938-1148 Expiration date: 10/31/2014 Transmittal Number: OK-14-0011 Supersedes Transmittal Number: Proposed Effective Date: Jan 1, 2015 Approval Date:
More informationHCBS: Getting Started with Implementation
HCBS: Getting Started with Implementation Presentation to ACL members by Cindy Freidmutter, CLF Consulting August 4 & 5, 2016 HCBS Presentation Agenda HCBS Framework How HCBS Works HCBS Start-up Challenges
More informationSpecialty 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
More informationMichigan Primary Care Transformation (MiPCT) Project Frequently Asked Questions
Michigan Primary Care Transformation (MiPCT) Project Frequently Asked Questions Demonstration Design 1. What is the Michigan Primary Care Transformation (MiPCT) Project? The Centers for Medicare and Medicaid
More informationDraft Children s Managed Care Transition MCO Requirements
Draft Children s Managed Care Transition MCO Requirements OVERVIEW On February 1 st, New York State released for stakeholder feedback a draft version of the Medicaid Managed Care Organization (MCO) Children
More informationSHOW-ME INNOVATION: Missouri s Health Care Homes Integrate Behavioral Health and Primary Care Jaron Asher, MD February 28, 2014
SHOW-ME INNOVATION: Missouri s Health Care Homes Integrate Behavioral Health and Primary Care Jaron Asher, MD February 28, 2014 Jaron Asher, MD Medical Director at Places for People in St. Louis, MO Chief
More informationPhysical Health Integration Within Behavioral Healthcare: Promising Practices
Physical Health Integration Within Behavioral Healthcare: Promising Practices 9:45 AM 10:45 AM Steering Toward Success: Achieving Value in Whole Person Care September 25 and October 26, 2017 The Healthier
More informationBi-Annual Stakeholder Meeting May 12, 2014
Bi-Annual Stakeholder Meeting May 12, 2014 Agenda 1. 1:00-1:05 Welcome and Introductions 2. 1:05-1:10 Inspection of Care Desk Review Jennifer Brezee, ValueOptions 3. 1:10-1:20 Retrospective Reviews Jennifer
More informationModel of Care Heritage Provider Network & Arizona Priority Care Model of Care 2018
Model of Care Model of Care 2018 Learning Objectives Program participants will be able to: List two differences between the Complex Care Management (CCM), and Special Needs Program (SNP) programs. Identify
More informationThe American Recovery and Reinvestment Act of 2009, Meaningful Use and the Impact on Netsmart s Behavioral Health Clients
The American Recovery and Reinvestment Act of 2009, Meaningful Use and the Impact on Netsmart s Behavioral Health Clients Updated March 2012 Netsmart Note: The Health Information Technology for Economic
More informationCMS Local Coverage Determination (LCD) of Psychiatric Partial Hospitalization Programs for Massachusetts, New York, and Rhode Island
CMS Local Coverage Determination (LCD) of Psychiatric Partial Hospitalization Programs for Massachusetts, New York, and Rhode Island L33626 Coverage Indications and Limitations Psychiatric partial hospitalization
More informationAlternative Payment Models and Health IT
Alternative Payment Models and Health IT Health DataPalooza Preconference May 8, 2016 Kelly Cronin, MS, MPH, Director, Office of Care Transformation, ONC/HHS HHS Goals for Medicare Payment Reform In January
More informationClinical Services. clean NYS Driver s License, fingerprinting, criminal record check, and approval from NYS Office of Mental Health.
Clinical Services Clinical Social Worker- Fee for Service Location: Wyandanch- Clinic Job Function: Provide direct clinical care to clients as needed as a member of a multi-disciplinary treatment. Qualifications:
More informationCognitive Emotional Social Behavioral functioning
TIP SHEET Health and Behavior Assessment and Intervention (HBAI) Services Coverage of Chronic Disease Self-Management Education Medicare and Medicare Advantage Purpose: The HBAI services are used to identify
More informationHealth Homes in KanCare
Health Homes in KanCare INTRODUCTION The term health home is unique to Medicaid Health homes are an option which states can choose to provide within their Medicaid programs A health home is not a building,
More informationMEDICAID MODEL DATA LAB
MEDICAID MODEL DATA LAB Id: OHIO State: Ohio Health Home Services Forms (ACA 2703) Page: 1-10 TN#: OH-12-0013 Superseeds TN#: OH-00-0000 Effective Date: 10/01/2012 Approved Date: 09/17/2012 Transmital
More informationPatient and Family Engagement: Strategies to Improve Health
Patient and Family Engagement: Strategies to Improve Health UHF & GNYHA 24 th Annual Symposium on Health Care Services in New York: Research and Practice David Cohen, MD, Maimonides Medical Center Overview
More informationTransition Period. Parallel Paths to Purchasing Transformation 2020: RSAs. Fully Integrated Managed Care System
2 Parallel Paths to Purchasing Transformation 2020: Fully Integrated Managed Care System Transition Period 2014 Legislative Action: SSB 6312 By January 1, 2020, the community behavioral health program
More informationWorking with Amerigroup Kansas:
Working with Amerigroup Kansas: Procedures and Answers for Behavioral Health Providers, Facilities and Community Mental Health Centers UPDATED December 2012 These are updates to the most common questions
More informationSeizing the Opportunity: Early Medicaid Health Home Lessons. By Kathy Moses and Brianna Ensslin, Center for Health Care Strategies MARCH 2014 B RIEF
Issue Brief Seizing the Opportunity: Early Medicaid Health Home Lessons By Kathy Moses and Brianna Ensslin, Center for Health Care Strategies MARCH 2014 h T e health homes provision of the Affordable Care
More informationSAMHSA Primary and Behavioral Health Care Integration (PBHCI) Program Grantees: Part 2
SAMHSA Primary and Behavioral Health Care Integration (PBHCI) Program Grantees: Part 2 Ken Bachrach, Ph.D., Clinical Director Jim Sorg, Ph.D., Director of Care Integration and IT Tarzana Treatment Centers
More informationVSHP/ Behavioral Health
VSHP/ Behavioral Health Deb Dukes & Dr Kelly Askins The contact numbers in the presentation apply to WEST Member Services ONLY. New numbers for EAST Member Services will be published and distributed by
More informationDSRIP 2017: Lessons Learned and Paving the Way for Success
DSRIP 2017: Lessons Learned and Paving the Way for Success Greg Allen, MSW (Moderator) Director, Division of Program Development and Management Office of Health Insurance Programs, New York State Department
More informationLeveraging Health IT to Risk Adjust Patients Session ID: QU2; February 19 th, 2017
Leveraging Health IT to Risk Adjust Patients Session ID: QU2; February 19 th, 2017 Tamra Lavengood, RN, BSN, MSN CPC Coordinator and Clinical Performance Coordinator Centura Health Physician Group, Centura
More informationJune 2017 NYS Department of Health NYS Office of Mental Health NYS Office of Alcoholism and Substance Abuse Services
Guidance for Behavioral Health Home and Community Based (BH HCB) Non-Medical Transportation Services for Adults in HARPs and HARP Eligibles in SNPs June 2017 NYS Department of Health NYS Office of Mental
More informationImproving Health Status through Behavioral Health Interventions
Comorbidity in the Dual Eligible Population: Improving Health Status through Behavioral Health Interventions PREPARED FOR THE CALIFORNIA ASSOCIATION OF HEALTH PLANS 2013 SEMINAR SERIES JUNE 25, 2013 BEACON
More informationAdult BH Home & Community Based Services (HCBS) Foundations Webinar JUNE 29, 2016
Adult BH Home & Community Based Services (HCBS) Foundations Webinar JUNE 29, 2016 June 30, 2016 Introduction & Housekeeping Housekeeping: Slides are posted at MCTAC.org Questions not addressed today will
More informationBehavioral Health Providers: The Key Element of Value Based Payment Success
Behavioral Health Providers: The Key Element of Value Based Payment Success December 6, 2017 Presented by: Andrew Cleek, Psy.D. Meaghan Baier, LMSW Goals of the Presentation Understand the intersect between
More informationNew Jersey Medicaid Medical Home Demonstration Project Report to the Legislature
New Jersey Medicaid Medical Home Demonstration Project Report to the Legislature November 2012 Division of Medical Assistance and Health Services NJ Department of Human Services Introduction In September,
More informationThe CCBHC: An Innovative Model of Care for Behavioral Health
The CCBHC: An Innovative Model of Care for Behavioral Health B R E N D A G O G G I N S, J D V I C E P R E S I D E N T O A K S I N T E G R A T E D C A R E M I C H A E L D A M I C O, L C S W D I R E C T
More informationThe Money Follows the Person Demonstration in Massachusetts
The Money Follows the Person Demonstration in Massachusetts Use of Concurrent 1915(b)(c) Waivers to Serve Elders and Adults with Disabilities Transitioning from Long-Stay Facilities HCBS Conference Arlington,
More informationMajor 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,
More informationThe Long and Winding Road-map: From Waiver Services to VBP and Other Stops Along the Way
The Long and Winding Road-map: From Waiver Services to VBP and Other Stops Along the Way Mental Health Association in New York State, Inc. Annual Meeting Gregory Allen, MSW Director Division of Program
More informationImplementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers
Implementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers Beth Waldman, JD, MPH June 14, 2016 Presentation Overview 1. Brief overview of payment reform strategies
More informationAccess to Adult BH HCBS for Non-Health Home Enrollees: The State Designated Entity. February 22, 2018
Access to Adult BH HCBS for Non-Health Home Enrollees: The State Designated Entity February 22, 2018 February 22, 2018 Agenda Overview of HARP and Adult BH HCBS What is a State Designated Entity? Becoming
More informationOverview Report Context. Getting Started with Monthly Overview Reports. Materials Needed. Metrics Captured In Overview Report
SIF Webinar: Overview Reporting and Organizational Relapse Prevention Planning Overview Report Context Getting Started with Monthly Overview Reports Juliann Salisbury Program Assistant, UW AIMS Center
More informationThe Patient Protection and Affordable Care Act Summary of Key Health Information Technology Provisions June 1, 2010
The Patient Protection and Affordable Care Act Summary of Key Health Information Technology Provisions June 1, 2010 This document is a summary of the key health information technology (IT) related provisions
More informationHEALTH HOME INTEGRATED PRIMARY AND BEHAVIORAL HEALTH CARE SERVICES
COMPARISON OF EXISTING SERVICES AND DELIVERY MODELS WITH DEFINITIONS PRIMARY CARE CASE MANAGEMENT (PCCM) Oklahoma s PCCM program is called SoonerCare Choice (SCC), in which each enrollee is linked to a
More informationAccomplishments and Challenges in Medicaid Mental Health Services
Accomplishments and Challenges in Medicaid Mental Health Services Innovation, Financing and Change June 5, 2008 Richard H. Dougherty, Ph.D. Accomplishments There has been significant reductions in state
More informationMassHealth Restructuring Overview
1 MassHealth Restructuring Overview State of the State, Assuring Access, Equity and Integrated Care Massachusetts League of Community Health Centers Marylou Sudders, Secretary Executive Office of Health
More informationClinical Services. clean NYS Driver s License, fingerprinting, criminal record check, and approval from NYS Office of Mental Health.
Clinical Services Clinical Social Worker- Fee for Service Location: Wyandanch- Clinic Job Function: Provide direct clinical care to clients as needed as a member of a multi-disciplinary treatment. Qualifications:
More informationRN Behavioral Health Care Manager in Primary Care Settings
RN Behavioral Health Care Manager in Primary Care Settings Integrated Care and the Expanding Role of Nurses Seattle Airport Marriott, SeaTac, WA Tuesday, January 9, 2018 The Healthier Washington Practice
More informationChildren s Medicaid System Transformation: HCBS Rates & SPA Rate Code Review. December 21, 2017
Children s Medicaid System Transformation: HCBS Rates & SPA Rate Code Review December 21, 2017 Introduction & Housekeeping Housekeeping: Slides are posted at MCTAC.org Questions not addressed today will
More informationDrug Medi-Cal Organized Delivery System (DMC-ODS) Waiver
Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver Medi-Cal Managed Care Advisory Committee Uma K. Zykofsky, LCSW Director, Behavioral Health Services Alcohol & Drug Administrator Waiver Authority
More informationSection 2703: State Option to Provide Health Homes for Enrollees with Chronic Conditions
Section 2703: State Option to Provide Health Homes for Enrollees with Chronic Conditions Center for Medicaid, CHIP, and Survey & Certification Centers for Medicare & Medicaid Services Background. A goal
More informationCertified Community Behavioral Health Centers and New York State s Healthcare Reform: Considerations for Providers
Certified Community Behavioral Health Centers and New York State s Healthcare Reform: Considerations for Providers November 30, 2015 Joshua Rubin HealthManagement.com Plan CCBHC basics NYS Health Reform
More informationARRA 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
More informationFQHC Behavioral Health Clinical Network Retreat
FQHC Behavioral Health Clinical Network Retreat 1 Behavioral Health Services Agenda Provider Enrollment Review Policies and Procedure Review Behavioral Health Boot Camp Questions 2 1 Disclaimer The materials
More informationThe evolution and future of the NY health home program
The evolution and future of the NY health home program Authors: Catherine Castillo, Senior Consultant, Tony Shi, Intern, Evan King, Executive Vice President Background In 2010, the Affordable Care Act
More informationEligibility. Program Structure and Process for Receiving Incentives
Overview of Medicare Incentives in the Centers for Medicare & Medicaid Services (CMS) Final Rule on Meaningful Use of Certified Electronic Health Records 1 Eligibility Medicare Eligibility: For Medicare
More informationState Medicaid Directors Driving Innovation: Continuous Quality Improvement February 25, 2013
State Medicaid Directors Driving Innovation: Continuous Quality Improvement February 25, 2013 The National Association of Medicaid Directors (NAMD) is engaging states in shared learning on how Medicaid
More informationMeaningful Use FAQs for Behavioral Health
Netsmart is your Meaningful Use technology partner with all the solutions you need to meet all Stage 1 Meaningful Use criteria so you don t have to integrate products from multiple vendors. For more information,
More informationStatewide Tribal Health Care Delivery Issues Log MH Medicaid Working Copy as of March 17, 2016
Statewide Tribal Health Care Delivery Issues Log MH Medicaid Working Copy as of March 17, 2016 # Category Agency Issue Description/Analysis Next Steps Timeframe/Target Date 1 BH-BHO BHA Require BHOs to
More informationapproved Nevada s State Innovation Model (SIM) Round October 2015 Division of Health Care Financing and Policy Introduction to SIM
Nevada State Innovation Model (SIM) October 2015 1 Introduction to SIM The Center for Medicare and Medicaid Services (CMS) approved Nevada s State Innovation Model (SIM) Round Two application to improve
More informationHealthPartners Inspire (SNBC) Overview
Draft HealthPartners Inspire (SNBC) Overview July 1, 2016 1 What is SNBC? Special Needs Basic Care (SNBC) began in 2008 Voluntary health plan option for enrollees with disabilities ages 18 through 64 who
More informationA National Survey of Medicaid Readiness for Electronic Visit Verification. Introduction
Introduction This survey is being conducted by Health Management Associates (HMA). The goal of the survey is to assess state Medicaid agency readiness to adopt Electronic Visit Verification (EVV) for Personal
More informationOhio Medicaid Budget and Behavioral Health Redesign
JMOC Update: Ohio Medicaid Budget and Behavioral Health Redesign Tracy Plouck, Director Ohio Department of Mental Health and Addiction Services Barbara R. Sears, Director Ohio Department of Medicaid September
More informationBulletin. DHS Provides Policy for Certified Community Behavioral Health Clinics TOPIC PURPOSE CONTACT SIGNED TERMINOLOGY NOTICE NUMBER DATE
Bulletin NUMBER 17-51-01 DATE February 27, 2017 OF INTEREST TO County Directors Social Services Supervisors and Staff Case Managers and Care Coordinators Managed Care Organizations Mental Health Providers
More informationTransitioning to Community Services: HARPS, Health Homes and SPOA
Transitioning to Community Services: HARPS, Health Homes and SPOA P R E S E N T E R : G L E N N L I E B M A N, C EO Mental Health Association in New York State, Inc. Brief History of Health and Recovery
More informationAdult BH HCBS Town Hall ROS Designated Providers. June 13, 2017
Adult BH HCBS Town Hall ROS Designated Providers June 13, 2017 June 28, 2017 2 Why Behavioral Health Transformation is Needed June 28, 2017 3 Why Behavioral Health Transformation is Needed In NYS, members
More informationNovember 2015 health.ny.gov
Opt Out Process Frequently Asked Questions (FAQs) New York s Delivery System Reform Incentive Payment (DSRIP) Program November 2015 health.ny.gov Table of Contents DSRIP OPT OUT FREQUENTLY ASKED QUESTIONS
More informationBCBSRI & Delivery System Transformation. Gus Manocchia, MD Senior Vice President & Chief Medical Officer March 11, 2016
BCBSRI & Delivery System Transformation Gus Manocchia, MD Senior Vice President & Chief Medical Officer March 11, 2016 1 Overview Systems of Care Overview & Highlights Primary Care to Risk Arrangements
More informationIntegrated Mental Health Care. Questions
Integrated Mental Health Care Closing the gap between what we know and what we do. Jürgen Unützer, MD, MPH, MA Questions Due to the large number of participants, it is not practical to take questions over
More informationChildren's System MCO Contracting Fair. November 6, 2017
Children's System MCO Contracting Fair November 6, 2017 2 Guiding Principles Behind Children s Health and Behavioral Health MC Transition Key components of the managed care transition is to: Early identification
More informationMedicaid and CHIP Payment and Access Commission (MACPAC) February 2013 Meeting Summary
Medicaid and CHIP Payment and Access Commission (MACPAC) February 2013 Meeting Summary The Medicaid and CHIP Payment and Access Commission (MACPAC) was established in the Children's Health Insurance Program
More informationMedicaid Managed Care Readiness For Agency Staff --
Medicaid Managed Care Readiness 101 -- For Agency Staff -- To Understand: Learning Objectives Basic principles of Managed Care as a payment vehicle for health care services The structure of the current
More informationACO Practice Transformation Program
ACO Overview ACO Practice Transformation Program PROGRAM OVERVIEW As healthcare rapidly transforms to new value-based payment systems, your level of success will dramatically improve by participation in
More informationJune 25, Shamis Mohamoud, David Idala, Parker James, Laura Humber. AcademyHealth Annual Research Meeting
Evaluation of the Maryland Health Home Program for Medicaid Enrollees with Severe Mental Illnesses or Opioid Substance Use Disorder and Risk of Additional Chronic Conditions June 25, 2018 Shamis Mohamoud,
More informationState Fiscal Year 2017 Validation of Performance Measures for Region 7 Detroit Wayne Mental Health Authority
Michigan Department of Health and Human Services State Fiscal Year 2017 Validation of Performance Measures for egion 7 Detroit Wayne Mental Health Authority Behavioral Health and Developmental Disabilities
More informationCost Estimates of Individual Assessment Tools In Arkansas Medicaid Population
Cost Estimates of Individual Assessment Tools In Arkansas Medicaid Population PREPARED BY: THE STEPHEN GROUP 814 Elm Street, Suite 309 Manchester, NH, 03102 Main: (603)419-9592 www.stephengroupinc.com
More informationTEHDI CONTINUUM OF CARE FOR AUDIOLOGISTS
TEHDI CONTINUUM OF CARE FOR AUDIOLOGISTS COORDINATING CARE USING HEALTH INFORMATION TECHNOLOGY (HIT) 101 Presented By: Mary Catherine Hess, MA OZ Systems Sponsored by the Texas Early Hearing Detection
More informationUnitedHealth Center for Health Reform & Modernization September 2014
Health Reform & Modernization September 2014 2014 UnitedHealth Group. Any use, copying or distribution without written permission from UnitedHealth Group is prohibited. Overview Why Focus on Primary Care?
More informationI. POLICY: DEFINITIONS:
GEORGIA DEPARTMENT OF JUVENILE JUSTICE Applicability: { } All DJJ Staff {x} Administration { } Community Services {x} Secure Facilities (RYDCs and YDCs) Transmittal # 18-1 Policy # 12.1 Related Standards
More informationPreparing for DSRIP: Legal and Strategic Issues for Long-Term Care Providers. LeadingAge New York Webinar
Preparing for DSRIP: Legal and Strategic Issues for Long-Term Care Providers LeadingAge New York Webinar November 10, 2014 Tracy E. Miller, Esq. Health Care Group Bond, Schoeneck & King, PLLC Delivery
More informationTransition to Community Living Initiative Diversion Process PASRR Manual for Adult Care Homes Licensed Under GS 131D 2.4
Transition to Community Living Initiative Diversion Process PASRR Manual for Adult Care Homes Licensed Under GS 131D 2.4 Presenters : Johnnie McManus, PASRR Coordinator 1 Important Changes in the PASRR
More informationRegion 1 IDN. Integrated Delivery Network Region 1: Partnership for Integrated Care
Region 1 IDN Integrated Delivery Network Region 1: Partnership for Integrated Care Region 1 IDN Request For Proposal Process The Region 1 IDN following a community driven process has elected to open all
More informationElizabeth Mitchell December 1, Transforming Healthcare in an Uncertain Environment
Transforming Healthcare in an Uncertain Environment Elizabeth Mitchell, President & CEO Network for Regional Healthcare Improvement 2017 We have a problem Health Spending as a Share of GDP United States,
More informationAlliance Behavioral Healthcare Level of Care Guidelines for State Funded Adult Mental Health and Substance Abuse Services
Alliance Behavioral Healthcare of Care Guidelines for State Funded Adult Mental Health and Substance Abuse s Mental Health (Effective 10/1/2012) The levels of care criteria provide a framework for the
More informationClinician Roster Information System (CRIS)
Clinician Roster Information System (CRIS) Training for Providers May 24, 2012 Suzanne Borys, Ed.D. Office of Research, Planning and Evaluation What Is CRIS? New procedures to track the credentials of
More informationJoining 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
More informationUCARE MODEL OF CARE SUMMARY FOR MH-TCM (February 2009)
UCARE MODEL OF CARE SUMMARY FOR MH-TCM (February 2009) The UCare Model of Care for Mental Health Targeted Case Management is designed to provide care for the child member and their families and adult members,
More informationService Review Criteria
Client Name: SAR#: Administrative Review Process notes: When documenting call outs to provider, please document the call in a patient note in Alpha the day the call is made. tes should be coded as Care
More informationDavid W. Eckert, LMHC, NCC, CRC Senior Consultant at CCSI s Center for Collaboration in Community Health
David W. Eckert, LMHC, NCC, CRC Senior Consultant at CCSI s Center for Collaboration in Community Health The Managed Care Technical Assistance Center of New York What is MCTAC? MCTAC is a training, consultation,
More information(c) A small client to staff caseload, typically 10:1, to consistently provide necessary staffing diversity and coverage;
309-019-0225 Assertive Community Treatment (ACT) Overview (1) The Substance Abuse and Mental Health Services Administration (SAMHSA) characterizes ACT as an evidence-based practice for individuals with
More informationIntegrated Care: Considerations for Quality. May 13, 2015 Megan Marx MPA Associate Director
Integrated Care: Considerations for Quality May 13, 2015 Megan Marx MPA Associate Director GoToWebinar Housekeeping: Attendee participation Your Participation Join audio: Choose Mic & Speakers to use VoIP
More informationkaiser medicaid and the uninsured commission on O L I C Y
P O L I C Y B R I E F kaiser commission on medicaid and the uninsured 1330 G S T R E E T NW, W A S H I N G T O N, DC 20005 P H O N E: (202) 347-5270, F A X: ( 202) 347-5274 W E B S I T E: W W W. K F F.
More informationTotal Cost of Care Technical Appendix April 2015
Total Cost of Care Technical Appendix April 2015 This technical appendix supplements the Spring 2015 adult and pediatric Clinic Comparison Reports released by the Oregon Health Care Quality Corporation
More informationNavigating 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
More informationMeaningful Use of EHR Technology:
Meaningful Use of EHR Technology: What Do the New Standards and Certification Criteria Mean for Your Organization? January 20, 2010 Mitchell J. Olejko Ropes & Gray LLP mitchell.olejko@ropesgray.com 415-315-6328
More informationBEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual
BEHAVIORAL HEALTH SERVICES PROVIDER MANUAL Chapter Two of the Medicaid Services Manual Issued March 14, 2017 State of Louisiana Bureau of Health Services Financing SECTION: TABLE OF CONTENTS PAGE(S) 1
More informationValue Based Payment WHAT IS THIS ALL ABOUT?
Value Based Payment WHAT IS THIS ALL ABOUT? 1 1 Agenda Welcome and Introductions RPC Introduction New York State s Vision Population Impacted What Does VBP Mean to Me as a BH Provider in NYS? What is Value
More informationMedicaid EHR Provider Incentive Payment Program. September 26, 2011
Medicaid EHR Provider Incentive Payment Program September 26, 2011 Definitions Electronic Health Record (EHR)*-An electronic record of health-related information on an individual that conforms to nationally
More informationOhio s Direct Workforce Initiative and Health Care Integration: Exploring Job Roles & Competencies
Ohio s Direct Workforce Initiative and Health Care Integration: Exploring Job Roles & Competencies University of Cincinnati Department of Internal Medicine The BeST Center Northeast Ohio Medical University
More information