advancing recovery
DESCRIPTION
Advancing Recovery. Laura Schmidt Dennis McCarty Learning Session 3: December 4, 2012. Advancing Recovery: Change Model. Four Conditions for Change Five Levers of Change Three Supports for Change. Four Conditions for Change. Understand customer needs Use walkthroughs - PowerPoint PPT PresentationTRANSCRIPT
Advancing RecoveryLaura Schmidt
Dennis McCarty
Learning Session 3: December 4, 2012
Four Conditions for ChangeFive Levers of ChangeThree Supports for Change
Advancing Recovery: Change Model
Understand customer needs• Use walkthroughs
Commitment from leadershipClear aim and purpose• Goal – Enhance long-term recovery
Supportive business case• Improve competitiveness
Four Conditions for Change
Financial analysis• Utilization and costs; billing codes
Regulatory and policy analysis• Regulatory barriers and facilitators
Inter-organizational analysis• Linkages to internal & external resources
Operations analysis• Enhance efficiency, reduce costs, training
Customer impact analysis• Reduced readmissions, improved recovery
Five Levers of Change
Partnership between payer and providers – joint goals
Use of Plan-Do-Study-Act rapid change cycles – NIATx
Technical assistance, coaching and learning collaborative• Medication Research Partnership
Three Supports for Change
Bup pts Percent0
20
40
60
80
100
120
Q1Q2Q3Q4Q5Q6Q7Q8
Maine: New buprenorphine pts
Etoh pts Pts screend % screened0
100
200
300
400
500
600
700
Q1Q2Q3Q4
Missouri: Screening for Etoh Meds
Pts transfrd Percent0
50
100
150
200
250
300
350
400
450
Q1Q2Q#Q4Q%Q6Q7Q8
Colorado: Pts transferred from dtx to
outpt
Maine allocated $500K for medicationDallas behavioral health organization did not
cover buprenorphineMissouri added contract flexibility to purchase
medications and physician timeParticipating centers increased revenues and
reduced expenses
Financial Analysis
Missouri and Maine revised licensure requirements to require staff physicians
Maine, Missouri, Rhode Island modified contract language
Regulatory and Policy Analysis
Treatment centers developed links to prescribersMaine’s SSA worked closely with MedicaidTreatment centers developed regional collaborations and
referral networksJoint purchasing reduced the cost of medication
Inter-organizational analysis
Treatment centers used walkthroughs to understand the patient experience and improve program efficiency and patient satisfaction
Missouri added billing codes after walkthroughs identified gaps in how to reimburse services
Treatment centers used rapid change cycles to test changes on a small scale before spreading
Operations Analysis
Treatment centers improved patient and referral satisfaction
West Virginia developed support groups for patients taking buprenorphine
Customer Impact Analysis
States and providers tried multiple change strategies to find ones that worked for them
Substantial barrier to adoption and change• Lack of funding for new services• Practitioner resistance• Staff turnover and lack of training• Weak data systems
Medication easier to implement • Continuing care required more extensive change
Successful change required provider and payer collaboration – both systems needed change
In summary …