Providing Stability & Innovation During Changing Times: Introducing Paul Ricci, CEO of Qualifacts + Credible

As the instability of the evolving health and human service market continues, executive teams across the nation are facing new and unprecedented challenges. The top question on all of our minds? How can we bring stability to our organizations – and ensure sustainability in the months ahead?

Re-thinking longstanding strategies and adopting new, innovative, customer-focused strategies are rarely ‘top of mind’ for executives operating in uncertain times… but while searching for a ‘roadmap’ to stability, successful leaders often find that innovation is the best path to success.

Monica E. Oss, OPEN MINDS’  CEO, and Paul Ricci, CEO of the newly merged Qualifacts + Credible organization, are two industry leaders who’ve embraced innovation to lead their organizations through current and past market disruptions. Join these two leaders for a unique discussion about how innovation, technology adoption, and customer-focused approaches can be the keys you need to unlock stability for your organization in today’s market.

Preparing For The Unknown: The EHR Functionality To Survive During & After A Pandemic — Results Of The 2020 National Behavioral Health EHR Survey

The COVID-19 pandemic has created substantial change across the entire health and human services industry. As thousands of Americans fell ill, provider organizations were challenged to shift to virtual/remote work and care delivery almost overnight. This required provider organizations to change what was previously considered necessary functionality and focus on a new set of key functionality to survive.

We can see this shift in functionalities in the results of the 2020 National Behavioral Health EHR Survey. Along with understanding changes in purchasing and implementation behavior and the focus on the Core 4 functionalities, we see a need for mobile, cloud-based storage, data mining/business intelligence, social determinants of health data collection and reporting, IT security services, and telehealth functionality. By implementing these functionalities, provider organizations increased their probability of not only surviving the global pandemic, but thrive as the pandemic slows and eventually ends.

This webinar was originally presented on February 16, 2021 by OPEN MINDS Senior Associate Joe Naughton-Travers. During this webinar we reviewed:

  • Findings of the 2020 National Behavioral Health EHR Survey
  • Strategic market trends related to EHR functionality and implementation
  • The importance of investing in EHR functionality to increase their competitive edge

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Building The Leadership Team For Tomorrow

This presentation was delivered by OPEN MINDS Senior Associate Paul Duck on February 11, 2021 at The 2021 OPEN MINDS Performance Management Institute. In the presentation, Mr. Duck discussed how to build a leadership team that brokers new ideas and drives change by leveraging organizational culture; create an engaged workforce that fits with your organization’s culture; and best practices for recruiting and retaining top talent.

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Preparing For The Unknown: A Sneak Peak At The 2020 National EHR Survey Results

The COVID-19 pandemic created substantial change across the health and human services industry. To understand the changes made and planned for EHR functionality during this changing time, we surveyed over 5,000 behavioral health provider organizations on their EHR purchasing and implementation behavioral and functionality status. Get a sneak peak of the 2020 National Behavioral Health EHR Survey results during this session courtesy of Qualifacts + Credible.

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The 2021 OPEN MINDS Performance Management Executive Survey: Where Are We On The Road To Value

The results are in! Download the 2021 OPEN MINDS Performance Management Executive Survey eBook: Where Are We On The Road To Value.

The survey was presented at The 2021 OPEN MINDS Performance Management Institute by OPEN MINDS Chief Executive Officer, Monica E. Oss.

The survey tracks adoption of value-based reimbursement by specialty provider organizations, including the dominant models and performance measures used. The survey will provide direction on how to make sure your organization keeps pace with the rest of the field.

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Preparing For The Unknown: The EHR Functionality To Survive During & After A Pandemic — Results Of The 2020 National Behavioral Health EHR Survey

Free Executive Web Briefing, Sponsored by Qualifacts + Credible

The COVID-19 pandemic has created substantial change across the entire health and human services industry. As thousands of Americans fell ill, provider organizations were challenged to shift to virtual/remote work and care delivery almost overnight. This required provider organizations to change what was previously considered necessary functionality and focus on a new set of key functionality to survive.

We can see this shift in functionalities in the results of the 2020 National Behavioral Health EHR Survey. Along with understanding changes in purchasing and implementation behavior and the focus on the Core 4 functionalities, we see a need for mobile, cloud-based storage, data mining/business intelligence, social determinants of health data collection and reporting, IT security services, and telehealth functionality. By implementing these functionalities, provider organizations increased their probability of not only surviving the global pandemic, but thrive as the pandemic slows and eventually ends.

Agenda

Join Joe Naughton-Travers, Senior Associate at OPEN MINDS, on February 16 to hear:

  • Findings of the 2020 National Behavioral Health EHR Survey
  • Strategic market trends related to EHR functionality and implementation
  • The importance of investing in EHR functionality to increase their competitive edge

New Service Lines & New Revenue Streams: Building A Diversification Strategy & Conducting A Feasibility Analysis

Executive Web Briefing, Sponsored by Qualifacts + Credible 

Relying on a single payer or revenue stream is becoming a risky proposition. Now, more than ever, the ability to evaluate and modify current services and to develop new services to meet the challenges and opportunities in the market is an essential skill all executives need to master.

During this important session, led by OPEN MINDS Senior Associate Joe Naughton-Travers, attendees learned a process for evaluating service line performance and repurposing or launching new revenue streams.

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CBHA’s Virtual Provider Sustainability Forum

Virtual Provider Sustainability Forum, Sponsored by Qualifacts + Credible

The Executive Webinars will be led by OPEN MINDS Senior Associates, Ken Carr, Joe Naughton-Travers, and Paul Duck, bringing over 30 years of finance, technology, data analysis and reporting experience in the health and human service field.

Forum Sessions:
1. Short Term Cash Management – Assuring Continued Operations
2. Revenue Maximization During Times Of Disruption – Building Top Line To Sustain Margins
3. Strategic Planning For Post-Disruption Recovery & Sustainability

A Game Plan for Building a Sustainable Certified Community Behavioral Health Clinic (CCBHC)

The goal of the Certified Community Behavioral Health Clinics (CCBHC) is to improve patient care across the healthcare spectrum, serving highly complex patients while avoiding the use of high-cost, low-return care models though community-based alternatives that improve care management. Based on the success of the first wave of CCHBC’s, Congress has acted five times to extend the demonstration project and has allocated $450 million (to date) for CCBHC expansion grants. The number of CCBHC’s have expanded from 66 in 2015, to 166 in 2020.  The Substance Abuse and Mental Health Services Administration (SAMHSA) has embraced the CCBHC concept of integrated care and behavioral health providers, who have long supported integrated care, are now looking to the CCBHC model as an economically viable way to support this model of care.

Indeed, CCBHC’s have an excellent opportunity to be leaders in the new integrated healthcare system if they can display the following specific values:

  1. Accessibility: All needed services – mental health, substance abuse treatment, and physical health care – are provided in-house or quickly, in proximity, within the community.
  2. Efficiency: Multiple services can be provided daily, with one patient visit instead of multiple visits.
  3. Connection: Electronic Health Records (EHR) are used across service lines to produce and track clinical and quality metrics.
  4. Accountability: A commitment to producing the array of quality metrics required for quarterly reporting, in nearly real time.
  5. Adaptability: A commitment to using bundled payment arrangements that help clinics adopt and utilize alternative payment models instead of fee-for-service.

To meet these core values, provider organizations, in many cases, have had to update their organization’s service lines, hire new staff, and implement or update Electronic Health Record systems (EHRs). These changes represent substantial economic and human resource expenses. While enhanced reimbursement and up-front grant dollars have helped to offset the expense, it still begs the question: “How does an organization sustain the model beyond the grant period?” (https://vbcforbh.com/are-you-really-ready-for-value-based-payment/)

Thinking Beyond Grant Funding

The recipients of the 2020 CCBHC Expansion Grant the funding stream are only guaranteed funding for two years. A few considerations are important. The first is that funding may not be renewed. Considering potential fiscal deficits expected from the COVID epidemic, there is a distinct possibility that additional funding will not be there. A second possibility is that state funding may supplant federal funding. As states grapple with the aftermath of a pandemic, fewer state dollars will be available.  Already, Nevada has made a 6% cut to Medicaid dollars (https://vbcforbh.com/nevada-moves-forward-with-6-medicaid-fee-for-service-rate-cut/).

SAMSHA was abundantly clear that grant participants should not expect more federal support. The newest round of grantees were given the task to: “Develop and implement plans for sustainability to ensure delivery of services once federal funding ends. Recipients should not anticipate the continued renewal of federal funding to support this effort. Federal funding is subject to funding availability and is also subject to a competitive grant award process. Recipients must develop and implement sustainability plans to ensure continued service once the grant ends. Recipients will be asked to report on sustainability plans” (https://www.samhsa.gov/sites/default/files/grants/pdf/fy-2020-ccbhc-foa.pdf).

The long-term sustainability of CCBHC programming requires a strategic response.

Community Behavioral Health Clinic (CCBHC) Sustainability and Value-Based Reimbursement

The CCBHC’s with an eye toward a future will be looking for alternative revenue streams immediately. The good news is that the CCBHC infrastructure of data driven health care focused on improved outcomes and diminished costs is an ideal match for payers who are looking for lower cost interventions and improved population health, and are using Value Based Reimbursement (VBR) to meet these goals.

The organizational readiness for CCBHC implementation has laid the groundwork for Value Based Programming.  The development of Evidenced Based Practices, addition of service lines, hiring new staff, affiliations with emergency care, adoption enhanced payment processes, and implementing and updating you Electronic Health Records (EHR) to capture clinical and quality data has positioned CCBHC to think about working with both private and public payers.

A Growing Value Based Culture

The OPEN MINDS 2019 State-By-State Update found that 28 of the 40 states with Medicaid managed care require health plans to implement alternative payment arrangements (APMs) with provider organizations. This is up from 22 states out of 39 states in 2017. And Value-Based processes are at the center of the trend. Organizational readiness for VBR follows a defined path:

(See OPEN MINDS Are You Really Ready for Value-Based Payment?)

The CCBHC is already this path, developing a VBR infrastructure. The next step is to define the unique value proposition of the CCBHC.

Defining the Unique Value Proposition to New Payors

A successful sustainability plan keeps the following goals in mind:

  • Have the Data: Understand internal unit costs and key performance indicators (KPI). Fortunately, the data needed to do this can be found in your CCBHC data. Use this to data to develop a picture of what the CCBHC does well, and where there are opportunities for improvement. Knowing strengths and possible risks will be important guides in rate negotiations.
  • Know the Customer: Research the payers in the market. For the health plans and accountable care organizations, know their structure and customers, their current service delivery network, executive teams, and their enrollment in your service areas. A CCBHC plan has flexibility to meet the changing needs of the marketplace. Alignment with those needs will make a CCBHC more attractive to payers that need services.  (See What Are Health Plans Actually Doing? and Trends in Behavioral Health: A Population Health Manager’s Reference Guide on the U.S. Behavioral Health Financing and Delivery System).
  • Prepare for the End-Game. Think about future meetings with health plan executives to discuss current contracts and proposed services as the CCBHC plan is developed. Be prepared with a proposal and assess readiness for newer payment models (Use the Value-Based Reimbursement Readiness Assessment).

Build Relationships Now

Avoid scrambling at the last moment for new funding streams. Remember, payers know that mental health and substance use disorders are the leading causes of disease burden in America.  This is further exacerbated by co-morbidities faced by people with mental health and substance use disorders who also suffer from cardiovascular disease, and diabetes, and other chronic diseases. The CCBHC is addressing this issue head on and that needs to be highlighted. To do this you can start by doing the following:

  • Build relationships with payers immediately: Reach as high into the payer organization as possible to develop those relationships. Then attempt to establish formal touchpoints. A scorecard with quarterly data will provide updates on key points that may be of value to the health plan. These interactions need to be succinct and to the point.
  • Develop a Pitch Deck: Prepare a brief (one or two slide) value story that describes how the CCBHC’s programs are differentiated in terms of quality and costs, and how they contribute to health care cost savings for the payer.
  • Leverage Informal Meetings: Attend conferences and industry meetings with target payers. These less formal venues allow for additional touchpoints to reiterate the value the CCBHC brings to the table, and the differentiating strengths.

Finally, connecting with health plans comes down to persistence.  Provider organizations need to find the right contact in network management, or whoever is leading their local plan and continue to reach out. In the end, relationship-building is still based on quality communication. The CCBHC model is the perfect framework to build relationships with payer organizations.