Andrew Cleek, PsyD. The Managed Care Technical Assistance Center of New York

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1 Andrew Cleek, PsyD

2 I. Introduction II. Readiness Assessment Results III. Addendum Results IV. Agency Readiness Benchmark Report V. Next Steps 2

3 The Community Technical (CTAC) is a training, consultation, and educational resource center available to all child and adult-serving agencies in New York State. Our goal is simple: to provide programs with a set of technical assistance, training activities and tools that promote effective care through efficient practices. 3

4 What is MCTAC? MCTAC is a training, consultation, and educational resource center that offers resources to all mental health and substance use disorder providers in New York State. MCTAC s Goal Provide training and intensive support on quality improvement strategies including business, organizational and clinical practices, to achieve the overall goal of preparing and assisting providers with the transition to Medicaid Managed Care. 4

5 Managed Care Readiness Assessment Data Collection and Analytics Data collection: online survey Focus of Analysis: Examine readiness and preparedness for the transition to Managed Care and identify areas where additional support is needed Report: MCTAC presenting aggregated data to relevant stakeholders 5

6 MMC Readiness Assessment This MMC Readiness Tool is designed to provide organizations with 11 domains of processes, practices and change management activities needed to effectively prepare for and function during the early stages of a business relationship with a Managed Care organization. When completed, the self-assessment tool offers a snapshot of the organization s current level of readiness as well as an assessment of the need for technical assistance. This tool may be helpful as a planning resource to guide organizations in their preparation and decision making activities. 6

7 Readiness Assessment Results for Child-Serving Organizations

8 276 Child Serving Agencies submitted Readiness Assessments On average, 60% of reimbursement was from Medicaid Only. 30% of agencies reported that less than 10% of reimbursement was from managed care. There are statistically significant differences by Region. There are statistically significant differences by Reimbursement. 8

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10 (42%) Agency Type Number of Agencies (13%) 87 (32%) 43 (16%) 20 0 OMH OASAS OCFS Other Agency Type 10

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12 MCTAC Readiness Assessment - Domains Domain Name Label in Graphs 1 Understanding MCO Priorities & Present Managed Care Involvement MCO Priorities 2 MCO Contracting Contracting 3 Communication /Reporting (Services authorization, etc.) Communication 4 IT System Requirements IT Level of Care (LOC) Criteria / Utilization Management 5 Practices Level of Care 6 Member Services/Grievance Procedures Member Services 7 8 Interface with Physical Health, Social Support and Health Homes Quality Management/Quality Studies/Incentive Opportunities Interface Quality 12 9 Finance and Billing Finance 10 Access Requirements Access 11 Demonstrating Impact/Value (Data Management & Evaluation Capacity) Evaluation Aggregate Total Score Total Score

13 13 Domain Average Score 1. MCO Priorities Contracting Communication IT Level of Care Member Services Interface Quality Finance Access Evaluation 2.63 Total Score 3.08 *Domain score is below total average score

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15 Domain Scores by Agency's Region MCO Priorities 2. Contracting 3. Communication NON NYC NYC Combined 4. IT

16 4.50 Domain Scores by Agency's Region * * * Level of Care 6. Member Services NYC NON NYC Combined 7. Interface 8. Quality 16

17 4.50 Domain Scores by Agency's Region * 2.87* * * Finance 10. Access 11. Evaluation Total Score NYC NON NYC Combined 17

18 Domain Scores by Agency's Managed Care Reimbursement 3.02* * 1.90* * MCO Priorities 2. Contracting 3. Communication Less than 10% More than 10% 4. IT

19 Domain Scores by Agency's Managed Care Reimbursement * 2.36* * Level of Care 6. Member Services 7. Interface 8. Quality Less than 10% More than 10% 19

20 Domain Scores by Agency's Managed Care Reimbursement * 2.81* * * Finance 10. Access 11. Evaluation Total Score Less than 10% More than 10% 20

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22 Number of Children Serving Agencies Providing Specific Services 131 (66.8%) crisis intervention services 127 (65.1%) community psychiatric treatment and support services. 120 (63.5%) psychosocial rehabilitation services 116 (60.1%) family peer support services 55 (28.6%) youth peer advocacy and training services. 53 (27.5%) crisis respite. 68 (35.2%) planned respite. 75 (39.1%) prevocational services. 136 (70.5%) care coordination. 49 (25.7%) supported employment. 107 (56%) habilitative skill building. 54 (28.3%) non-medical transportation. 135 (71.1%) family caregiver supports and services. 113 (59.8%) community advocacy and support. 20 (10.3%) day habilitation services. 22 (11.5%) adaptive and assistive equipment. 23 (12%) accessibility modifications. 19 (9.9%) palliative care.

23 Screening and Evaluation Tools: 73% of agencies reported that they conduct at least some type of specific screening and evaluation tool including the CANS, SDQ, CBCL, BDI, UCLA PTSD Specific Treatment Models: 83% of agencies reported that they use specific treatment models including CBT variations, MI, 12 Step, Family Therapy models Measures Used to Track Outcomes: 86% of agencies reported specific outcome measures including treatment plans, number of ER/Hospital Visits, CANs, OASAS Client Data System, Pre/post or satisfaction surveys

24 Services offered by Agencies through Collaboration Crisis Intervention Services Community Psychiatric Treatment and Support Services Psychosocial Rehabilitation Services Family Peer Support Services Youth Peer Advocacy and Training Services Care Coordination Habilitative Skill Building Family Caregiver Supports and Services Crisis Respite N %

25 Services offered by Agencies through Collaboration Planned Respite Prevocational Services Supported Employment Community Advocacy and Support Non - Medical Transportation Day Habilitation Services Adaptive and Assistive Equipment Accessibility Modifications Palliative Care N %

26 Agencies N % Have a system in place to orient families to the rules and expectations of the program Train and supervise staff on trauma informed principles and practices Have a system in place to ensure that our physical environment is safe and welcoming for consumers. Develop rules and regulations that are sensitive to the needs of caregivers and children who have experienced trauma. Have a system in place to ensure that the suggestions, needs, and perspective of families, informs the decisions we make. Have a clearly defined plan or protocol for management of crises with families that have been clearly communicated to all staff Services focus on what happened to you rather than what's wrong with you (or collaborating agencies) are implementing at least one evidence-based trauma treatment approach to help families heal from past traumatic experiences Routinely screen and assess for trauma in caregivers and children Have a supervisory process to address the impact of our work on the staff s emotional and physical wellbeing

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31 Assessment / Work Plan Development Tool Available Online 31

32 Important Limitations of the Data Each agency submitted a survey based on selfreport. The benchmarking tool is based on scores relative to agencies that completed the assessment. Agencies that have not submitted the assessment may differ in significant ways. 32

33 60 Using a work plan template, individualized results of the readiness assessment, and a menu of suggested activities in areas of greatest need, agencies can develop individual strategies to support the transition to managed care.

34 Domain Readiness Score Improvement Tasks Performance Measure Resources Needed Funding Source Estimated Dated of Completion MCO Priorities Contracting Communication IT Level of Care Member Services Interface Quality Finance Access Evaluation

35 Business Best Practices Services Best Practices Professional Development Value Based Practices System Redesign 35

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37 Tools Timeline Matrix Completed Launched July 15, 2015 Billing/Claims Completed August 2015 Glossary of Terms Completed 37

38 Tools Timeline Credentialing September 2015 Chargemaster September 2015 Utilization Management September/October 2015 Outputs to Outcomes Fall 2015 Plan of Care Tool (Proposed) Proposed 38

39 A comprehensive and interactive online tool that provides agency staff with the information needed to successfully engage with MCOs. Launched July 15, ,772 Page views the first week 6,373 page total views, as of 8/11/15 39

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44 @CTACNY