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

(1)

The M anaged Care Technical Assistance Center of New York

(2)

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I. Introduction

II. Readiness Assessment Results

III. Addendum Results

IV. Agency Readiness Benchmark Report

V. Next Steps

(3)

The Community Technical Assistance Center of New York

(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.

(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.

(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

(6)

• 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.

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MMC Readiness Assessment

(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.

(9)

(10)

10

116 (42%)

36 (13%)

87 (32%)

43 (16%)

0

20

40

60

80

100

120

140 OMH

OASAS

OCFS

Other

Num

be

r of Age

ncie

s

Agency Type

(11)

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12

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

5 Level of Care (LOC) Criteria / Utilization Management

_Practices

Level of Care

6 Member Services/Grievance Procedures

_{Member Services}

7 Interface with Physical Health, Social Support and

_{Health Homes}

_Interface

8 Quality Management/Quality Studies/Incentive

_{Opportunities}

Quality

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

3.34 2. Contracting

3.20 3. Communication

2.67 4. IT

3.17 5. Level of Care

2.87 6. Member Services

2.85 7. Interface

3.83 8. Quality

2.82 9. Finance

3.21 10. Access

3.32 11. Evaluation

2.63 Total Score

3.08

(14)

(15)

3.29

3.09

2.56

3.11

3.44

3.47

3.07

3.40

3.49

3.00

2.38

2.98

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00 1. MCO

Priorities

2. Contracting

3. Communication

4. IT

Domain Scores by Agency's

Region

(16)

16

2.76

2.62

3.88

2.65

3.21

3.39

3.87

3.21 2.50*

_2.40*

3.50 2.52*

0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50

5. Level of Care

6. Member

Services

7. Interface

8. Quality

Domain Scores by Agency's

Region

(17)

3.06

3.19

2.45

2.97

3.57

3.83

3.09

3.41 2.96*

_2.87*

2.40*

2.82*

0.00 0.50 1.00 1.50 2.00 2.50 3.00 3.50 4.00 4.50

9. Finance

10. Access

11. Evaluation

Total Score

Domain Scores by Agency's

Region

(18)

18

3.02*

2.68*

1.90*

2.79*

3.64

3.65

3.38

3.64

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00 1. MCO

Priorities

2. Contracting

3. Communication

4. IT

Domain Scores by Agency's

Managed Care Reimbursement

(19)

2.38*

2.36*

3.77 2.44*

3.25

3.13

3.96

3.13

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50 5. Level of

Care

6. Member

Services

7. Interface

8. Quality

Domain Scores by Agency's

Managed Care Reimbursement

(20)

20

2.80*

2.81*

2.31*

2.66*

3.68

3.96

2.96

3.49

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50 9. Finance

10. Access

11. Evaluation

Total Score

Domain Scores by Agency's

Managed Care Reimbursement

(21)

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Number of Children – Serving Agencies Providing Specific Services

131 (66.8%) crisis intervention

services

55 (28.6%) youth peer advocacy and

training services.

127 (65.1%) community psychiatric

treatment and support services.

53 (27.5%) crisis respite.

120 (63.5%) psychosocial

rehabilitation services

68 (35.2%) planned respite.

116 (60.1%) family peer support

services

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.

20 (10.3%) day habilitation services.

113 (59.8%) community advocacy

and support.

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

N

%

Crisis Intervention Services

78

80 Community Psychiatric Treatment and Support

Services

75

86 Psychosocial Rehabilitation Services

58

65 Family Peer Support Services

68

70 Youth Peer Advocacy and Training Services

82

60 Care Coordination

71

88 Habilitative Skill Building

58

64 Family Caregiver Supports and Services

59

80

(25)

Services offered by Agencies through

Collaboration

N

%

Planned Respite

96

71 Prevocational Services

79

62 Supported Employment

90

62 Community Advocacy and Support

65

67 Non - Medical Transportation

75

55 Day Habilitation Services

85

53 Adaptive and Assistive Equipment

91

54 Accessibility Modifications

86

52

(26)

Agencies…

N

%

Have a system in place to orient families to the rules and expectations of the

program.

84

89 Train and supervise staff on trauma informed principles and practices.

71

75 Have a system in place to ensure that our physical environment is safe and

welcoming for consumers.

88

94 Develop rules and regulations that are sensitive to the needs of caregivers and

children who have experienced trauma.

79

84 Have a system in place to ensure that the suggestions, needs, and perspective of

families, informs the decisions we make.

84

89 Have a clearly defined plan or protocol for management of crises with families that

have been clearly communicated to all staff.

79

84 Services focus on ‘what happened to you’ rather than ‘what's wrong with you’.

82

87 (or collaborating agencies) are implementing at least one evidence-based trauma

treatment approach to help families heal from past traumatic experiences.

72

77 Routinely screen and assess for trauma in caregivers and children

69

73 Have a supervisory process to address the impact of our work on the staff’s

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Assessment /

Work Plan

Development

Tool –

(32)

• Each agency submitted a survey based on self-

report.

• 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

(36)

(37)

Tools

Timeline

Matrix

Completed

Launched July 15, 2015

Billing/Claims

Completed

August 2015

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Tools

Timeline

Credentialing

September 2015

Chargemaster

September 2015

Utilization Management

September/October 2015

Outputs to Outcomes

Fall 2015

(39)

A comprehensive and interactive online tool that provides

agency staff with the information needed to successfully

engage with MCOs.

Launched July 15, 2015 – 3,772 Page views the first week

6,373 page total views, as of 8/11/15

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[email protected]