Behavioral Health Learning Group Coordinated by: November 16, 2016 Record of Learning Behavioral Health Participants • Jim Schmidt, OhioHealth • Kenton Beachy, Mental Health America of Franklin County • Jennifer Sheets, Concord Counseling • Judy Burkholder, OhioHealth • King Stumpp, Netcare Access • Leslie Fritz, Syntero • Amy Walton, PrimaryOne Health • Jamie McKenna, Directions for Youth and Families Healthcare Collaborative of Greater Columbus • Carly Mesnick, Mount Carmel Health System • John Leite • Alex Meyer, CompDrug • Michelle Missler • Joe Niedzwiesdski, North Central Mental Health Services • Krista Stock Shared Learning Discussion Purpose: Share and discuss regional, state, and national emerging activities and the implications for behavioral health organizations. Discussion: What are the latest updates on Ohio’s behavioral health redesign and collaboration with managed care organizations? ü BH redesign start data July 1, 2017. This is a long time coming and providers are ready for it to be implemented. Will change how behavioral health providers do business with payers and how they collaborate with others. ü Medicaid has a goal of 50% of providers in value-based contracts by 2019 (i.e., bundled rates, case rates, incentives such as shared risk) ü Organizations will need to be proactive in contacting MCOs defining and communicating their value proposition for the managed care plans. ü Data is still in silos (i.e., MITS, MCOs). As data becomes more integrated, providers and payers will have a better understanding of quality and cost. ü Medicaid/MCOs view innovation as important and wants to hear about innovative activities by providers that can add value for patients and payers. ü Redesign is compelling BH providers to seek out new IT systems (i.e., EHRs) to help them capture data and report internally and externally. Also important is how IT systems integrate with others (i.e., health systems/hospitals, HIE) ü Link to Ohio’s Behavioral Health Redesign website http://bh.medicaid.ohio.gov and training opportunities and resources http://bh.medicaid.ohio.gov/training Possible resource for managed care contracting consulting for behavioral health providers: Katie Colgan, VP Business Development and Managed Care Contracting, Strategic Healthcare, Katie.colgan@shcare.net Strategic Guidance Purpose: Help behavioral health organizations transform in a value-based system. Discussion: How are behavioral health providers contributing to value-based behavior?
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Trying to understand value-based goals – short-term-long-term – prevention approaches Communicated based services Speeding up initial engagement processes Managing patient populations: SDMIs, frequent utilizers, hospital admissions, physical health issues and complications, safety and incarceration, follow-up and care management Housing first, and other basics Cohesion along the continuum of care Frequency of services, keeping people out of hospitals, looking at ISPs, training evidenced based practices, ADAMH funding to cover alternative services more crisis acute behavioral health services Productivity requirements [lowering expectations] Population health management Looking at physical issues impeding mental health and vise versa Value-based diversion from incarceration Transportation/housing/fresh food Metric tracking will benefit value-based care Being better at follow-up with referrals [closing referral loop], care plans Identifying BH issues earlier on – addressing earlier In-house warm hand off In primary care, more ability to help manage BH issues that complicate health conditions Helping keep people out of hospitals Frequency of services – what is really medically necessary – clear treatment plan-working document Productivity – stable cts vs. inconsistent cts Evidence-based practices
ü ü ü ü ü ü ü ü ü ü ü ü ü ü What opportunities are emerging for behavioral health providers to work collaboratively with primary care and other providers and payers? ü ED to treatment center linkage ü Identifying co-morbid conditions and treat appropriately ü Coordination of care to deal with problems and symptoms ü Recognizing the array of problems and how to attach appropriate services ü EHR, parity, Clinisync, Payers, Integrated care ü Primary care coming to them ü Substance OD in ED – referrals to connect people ü Build partnerships with community agencies, referrals for crisis ü Primary care seeking BH providers out ü Two-way communication ü Access for BH services for older/Medicare population ü Primary care integration is moving from concept to reality. Need to do a better job of looking at the whole person to address needs
HCGC will follow up with the group about 2017 learning group sessions. Next regional Learning Session: Moving from Volume to Value: A Multi-Stakeholder Perspective December 9, 8:30 – 11:30 am Register at www.hcgc.org/registration/ Learning session value survey: xx (2) Very High Value xxxxxxxxx(9) High Value Medium Value Low Value No Value What are the key reflections you are taking away from today’s session? • Value-based care components • Where gaps are in clients/patients needs • Discussion on ideas for value-based care and what everyone is doing to move in this direction. • Good discussion on current topics in both BH and primary care • Things to think about regarding BH redesign • Speaker: LeeAnn Mattes, MHAFC Ombudsman to talk about navigating the BH system and how to contact her; attendees can take literature back to their practitioners. • Lots of changes are coming next year and in the near future