The OPEN MINDS Research and Consulting team is comprised of over 70 professionals with specific research and management expertise and experience in addiction treatment, mental health and social service fields. Meet our team...
Strategic Management: Organizations with limited resources have little margin for error, particularly in a rapidly changing environment that requires re-evaluation of mission, vision, values, customers, programming, and funding. Learn more...
Technology & Information Management: Technology systems are essential to the operations and management of behavioral health and social service organizations. These organizations require and rely upon practice management, managed care, accounting, human resources, and consumer assessment & outcomes software. Learn more...
Leadership & Governance: The health and human service landscape is constantly changing. Changing with it it is the role of the board of directors. Boards of for-profit, not-for-profit, and governmental agencies all find their needs for information and their responsibilities shifting. Learn more...
Marketing & Innovation: Privatization, consolidation, and competitive bidding of behavioral health, MR/DD, and children's services have resulted in serious threats, as well as tremendous opportunities. This rapidly changing environment demands an understanding of customers, competitors, market opportunity, and how to successfully compete. Learn more...
Financial Management Consultation
Behavioral health and social service organizations have experienced environmental changes that directly effect their financial performance and stability. Tight budgets, changes in financial reimbursement models, reduced fees and managed care have resulted in loss of business, significant collections and cash flow problems, as well as deficits/losses. In order to survive and thrive, behavioral health and social services organizations must be able to determine and control the cost of delivering services, set target pricing to succeed in a competitive environment, assume and manage risk, plan for and achieve a reduced cost structure through operational efficiencies and develop compensation models that improve productivity levels by aligning employee's interests with the interests of the organization.
Financial Management & Financial Risk Management
OPEN MINDS financial management and financial risk management consulting is designed to apply cutting-edge financial management models and techniques to behavioral health and social service organizations. In addition to offering technical expertise, OPEN MINDS is adept at applying these principles within the unique culture and construct of mission driven organizations. Our financial management and financial risk management consulting engagements have included:
- Medicaid Billing Assessment
- Case rate and capitation rate analysis and development
- Incurred but not received (IBNR) calculations
- Financial risk management systems
- Budget and pro forma development
- Cost accounting system assessments
- Development of performance-based compensation models
- Due diligence for potential acquisitions and partners
Risk Management & Compliance
Risk management issues, including compliance, have been key issues for behavioral health and social service executives for several decades. Prevention of critical client incidents and assuring compliance with public policy and best practice are on-going concerns. However, new risk management issues have arisen in the past few years. Compliance planning is now required to assure adherence with all applicable federal, state, and local laws, rules, and regulations as well as with the program requirements of federal and state sponsored health plans, such as Medicare and Medicaid. In addition, since Congress passed the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the U.S. Department of Justice's Office of the Inspector General has been mandated to establish programs to detect health care fraud and abuse as well as to encourage the public to report it. Most importantly, HIPAA also broadened the definition of 'knowing and willful conduct' with regard to the civil provision of the Social Security Act to include acts of 'deliberate ignorance' by providers with respect to information and regulation.
OPEN MINDS risk management and compliance consulting is designed to assist behavioral health and social service organizations to:
- Fully comprehend the framework, requirements and operation of a compliance program
- Understand the risks and ramifications associated with failure to comply
- Determine the components of an effective compliance program and how to operationalize them within their organization on an on-going basis
- Secure tools that enable efficient and effective implementation of a compliance program
OPEN MINDS consultants have assisted behavioral health and social service agencies in the development of their corporate compliance plans, conducted preliminary compliance audits of key risk areas (including billing and claims payment, medical record documentation, admissions and referral mechanisms, and provider credentialing and contracting) and assisted agencies to develop corrective action plans, as well as developed and delivered compliance training programs.