July 24, 2018

Behavioral Health IMC Update (August)

Diane Halo, Project Manager for Integrated Managed Care, and the Practice Transformation team, Jenna, Martin and Sam, have been very busy meeting with Behavioral Health Providers to ready them for Integrated Managed Care (IMC). 

They are working with Behavioral Health (BH) providers one on one.  Each BH provider will be required to complete the MeHAF Assessment and the Billing/IT Toolkit Assessments.  The GCACH staff are here to help the BH providers in completing these assessments.  GCACH feels that this approach will be the most beneficial as it will provide a comprehensive assessment of a practices current state.  These two assessments will help determine provider readiness and capacity for Integrated Managed Care.  After the assessments have been completed the GCACH staff will analyze the results and develop a transformation plan for the organization. This plan will detail quantitative results from the MeHAF, strengths, opportunities, and SMART goals for the behavioral health organization. PTNs will regularly meet with the behavioral health organizations and be available as a resource even after the transformation work is complete.

In addition to working with each BH providers, three Workgroups have been developed as part of the Integrated Managed Care Transition Plan.  The Provider Readiness Workgroup, Integrated Managed Care Communications Workgroup, and the Early Warning System Workgroup.

The Provider Readiness Workgroup is a group consisting of all the BH Providers, MCOs, HCA, and GCACH staff.  This workgroup will meet bi-weekly. The goals are to identify and resolve IT/EHR issues including but not limited to:

  • MCO billing capacity
  • EHR compatibility
  • Provider data reporting requirements
  • Technical Assistance needed by providers
  • Credentialing

The Integrated Managed Care Communications Workgroup is a work group with the MCOs, BHO, HCA, GCACH staff, Consumer Representatives, Navigators, Care Coordinators, Community health workers, Area Agencies on Aging, and BH Providers.  This workgroup will meet once a month. The goals of this workgroup are to:

  • Provide recommendations and work to engage consumers and providers in system change efforts related to Integrated Managed Care (IMC).
  • Ensure that consumers maintain confidence and continuity in the care they are receiving.
  • Ensure a smooth transition to IMC through the development of clear communications materials, client notifications, and transparent transition process.
  •  Leverage existing structures and avenues to collaborate with consumer groups, to gather consumer perspectives, and identify consumer concerns or gaps in understanding.

The Early Warning System Workgroup with BHO, BH Providers, HCA, Criminal Justice System Representatives, Law Enforcement, EMS, MCOs, and GCACH Staff. This workgroup will meet once a month.  The goal of this workgroup is to develop recommendations for an Early Warning System that allows a feedback loop and triage process to identify clients who may be falling through the cracks given the transition to Integrated Managed Care and resolve system issues as they arise.  As a group we would like to have it operational by January 1, 2019 and it would be ideal to have it up and running a few months before that in order to collect some baseline data.