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  • The Managed Care Technical Assistance Center of New York

    Andrew Cleek, PsyD

  • The Managed Care Technical Assistance Center of New York

    2

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

  • The Managed Care Technical Assistance Center of New York

    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.

  • The Managed Care Technical Assistance Center of New York

    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.

    MCTACs 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

  • The Managed Care Technical Assistance Center of New York

    Managed Care Readiness Assessment

    5

    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

  • The Managed Care Technical Assistance Center of New York

    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 organizations 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

    MMC Readiness Assessment

  • The Managed Care Technical Assistance Center of New York

    Readiness Assessment Results for Child-Serving Organizations

  • The Managed Care Technical Assistance Center of New York

    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

  • The Managed Care Technical Assistance Center of New York

    9

  • The Managed Care Technical Assistance Center of New York

    10

    116 (42%)

    36 (13%)

    87 (32%)

    43 (16%)

    0

    20

    40

    60

    80

    100

    120

    140

    OMH OASAS OCFS Other

    Num

    ber o

    f Age

    ncie

    s

    Agency Type

    Agency Type

  • The Managed Care Technical Assistance Center of New York

    11

  • The Managed Care Technical Assistance Center of New York

    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

    MCTAC Readiness Assessment - Domains

  • The Managed Care Technical Assistance Center of New York

    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

    *Domain score is below total average score

  • The Managed Care Technical Assistance Center of New York

    14

  • The Managed Care Technical Assistance Center of New York

    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. MCOPriorities

    2. Contracting 3.Communication

    4. IT

    Domain Scores by Agency's Region

    NON NYC NYC Combined

  • The Managed Care Technical Assistance Center of New York

    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. MemberServices

    7. Interface 8. Quality

    Domain Scores by Agency's Region

    NYC NON NYC Combined

  • The Managed Care Technical Assistance Center of New York

    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

    NYC NON NYC Combined

  • The Managed Care Technical Assistance Center of New York

    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. MCOPriorities

    2. Contracting 3.Communication

    4. IT

    Domain Scores by Agency's Managed Care Reimbursement

    Less than 10% More than 10%

  • The Managed Care Technical Assistance Center of New York

    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 ofCare

    6. MemberServices

    7. Interface 8. Quality

    Domain Scores by Agency's Managed Care Reimbursement

    Less than 10% More than 10%

  • The Managed Care Technical Assistance Center of New York

    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

    Less than 10% More than 10%

  • The Managed Care Technical Assistance Center of New York

    21

  • The Managed Care Technical Assistance Center of New York

    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.

  • The Managed Care Technical Assistance Center of New York

    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

  • The Managed Care Technical Assistance Center of New York

    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

    Crisis Respite 108 75

  • The Managed Care Technical Assistance Center of New York

    Services offered by Agencies through Collaboration

    N %

    Planned Respite 96 71

    Prevocational Services 79 62

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