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Behavioral Health Insights

Behavioral Health Insights

COLLABORATION

One of the things that I am excited about with respect to the development of UHA is the potential for collaboration between provider members.  In order for UHA to provide maximum value and return for its member organizations, our various committees will provide both structure and guidance in a number of key areas.  Among the committees that we plan on having are Clinical Integration, Quality and Finance.   The Clinical Integration Committee will focus on defining quality-based services through appropriate clinical protocols.  Our Quality Committee will review data on various metrics and make recommendations for improvements.  The Finance Committee will focus on how performance dollars are allocated among the various provider members.  
Jeff Forman
June 29, 2021
Behavioral Health Insights

WHAT TO DO WHILE WAITING FOR JANUARY 2022 (Part 1)

While we know that changes to Ohio Behavioral Health Medicaid are imminent, providers are currently encumbered by the lack of specifics on how both performance contracting and care coordination will look at the beginning of CY 2022. One thing that I would suggest that providers begin to work on is generating reports through their EHR.  One such report would be to collect data on the cost of providing treatment services to their clients.  This should be able to be determined through most BH EHRs without much intensive report writing efforts. Generating this type of information will reveal some interesting insight on the resources that encompass client treatment.  Providers could then cross-reference this information to diagnosis and get a good idea about what costs are involved in treating various behavioral health conditions.
Jeff Forman
June 15, 2021
Behavioral Health Insights

UHA- WHY WE’RE DOING IT

I have spent a good part of my working life involved with behavioral healthcare (BH).  I have seen BH evolve from a carved-out niche to a full-blown participant in main stream health care.  When I first became exposed to the business in 1987, community mental health boards controlled almost all of the available funding including Medicaid.  Many changes have occurred in the interim such as the Mental Health Act of 1988, Medicaid going from cost reimbursement to fee for service (2010) and the BH Medicaid carve-in implementation (2018).   Now Ohio BH is proceeding toward full-integration with physical healthcare.  The Ohio Department of Medicaid (ODM) has announced its intention to have its Managed Care Providers (MCPs) focus on both performance contracting and care coordination.  On the surface, these changes may appear to be daunting, especially to smaller BH providers.  I recognize this and I want to help develop a framework that allows smaller organizations to band together and build the infrastructure necessary to thrive in this new environment.  Collaborating and sharing resources will allow UHA member providers to access enhanced revenue opportunities without having to shoulder all of the burdens associated with building infrastructure that is necessary to analyze data…
Jeff Forman
May 13, 2021
Behavioral Health Insights

PERFORMANCE CONTRACTING

Late last week, the Ohio Department of Medicaid (ODM) announced which managed care plans (MCPs) will implement the state’s new vision for providing care to its three million plus Medicaid recipients.  Three of its current providers (CareSource, Molina and United Health Care) and three new insurers (Humana Health Plan of Ohio, AmeriHealth Caritas of Ohio and Anthem Blue Cross and Blue Shield) have been selected.  This new arrangement is scheduled to begin at the start of CY 2022.  We will likely see a great deal of activity take place over the next nine months to implement the state’s new vision for Medicaid.   How will these changes impact behavioral healthcare (BH) providers in Ohio?  While we have a good idea about the general direction that ODM wishes to take based on the draft MCP agreement posted on their website, specific information will gradually become known as the process plays out during the upcoming nine months.  One of the prominent changes that we can expect involves the implementation of performance contracting.   In the “Briefing Document” that ODM sent out late last week, they emphasize the following: “Provide more flexibility in establishing alternative payment models with providers who focus on patient…
Jeff Forman
May 13, 2021