When it comes to the current crisis, every health and human service organization is in a different position. Hospitals are swamped (see U.S. Hospitals Prepare For A COVID-19 Wave and Flood Of COVID-19 Patients Could Swamp Hospitals). Nursing homes and assisted living programs have enacted quarantines and other measures to prevent exposure (see Preparing For COVID-19: Long-Term Care Facilities, Nursing Homes and Surging Health Care Worker Quarantines Raise Concerns As Coronavirus Spreads). But where are community-based specialty provider organizations in this? It’s tough out there.
A new survey, Summary of CBHA Member Survey on the Effects of COVID-19, of the members of the California Council of Community Behavioral Health Agencies (CBHA), found that the past few weeks have had a significant impact on consumers, the professionals who serve them, and the community-based provider organizations. I noted four key takeaways in the survey results:
Consumer health status 33% of respondents indicated that they have clients who are too sick to engage in treatment. However, many indicated that they are unsure what the reason for lack of engagement is for many of their clients and if it is COVID-19 related or not. Additionally, one agency indicated that they have lost contact with many of their clients who are experiencing homelessness.
Revenue decreases Revenue is down. Respondents indicated that they have stopped groups and residential intakes and are primarily serving clients through telehealth. One agency indicated that 20% of clients who are offered telehealth services decline to engage in this modality. Another agency indicated that it is difficult to serve children via telehealth.
The cost of additional infrastructure The executives surveyed identified two needs — telehealth equipment and personal protective equipment. Expanding telehealth services requires investing in infrastructure — laptops, cameras, headsets, etc. — and providing enhanced support to staff for training and managing issues with utilizing telehealth platforms. The executives also cited the need for more extensive personal protective equipment including masks, sanitizing wipes and products and gloves — particularly for those staff who continue to provide field-based services.
The staffing conundrum Data suggests that 10% of members have already furloughed staff. Approximately 13% have terminated staff positions. Several CBHA member agencies (33%) indicated they are planning to furlough or terminate staff positions if there is no increase in revenue.
Last Friday, March 27, CBHA held a virtual town hall to present and discuss the survey results. During the town hall a fifth ‘significant challenge’ emerged — cash flow. The possible solutions to the situation are varied. San Francisco county is allowing provider organizations with fee-for-service contracts to invoice for a twelfth of the units contracted if they document services that were expected but unable to be delivered. Three northern California counties just sanctioned a 15 to-20% rate increase across all codes between now and July 1. Some counties are providing reimbursement for reduced services or cancelled services. Camille Schraeder, chief program officer of Redwood Quality Management Company (which manages seven provider organizations in a northern California county), advises executives of community-based provider organizations to try to negotiate immediate temporary rate increases with payers and health plans. To do that, she said, it is essential to build a case for the role of the provider organization in serving vulnerable populations like the homeless and the elderly, the effects of any possible service disruptions, and the need for urgent action.
The pandemic is a health crisis with two key elements. First continuing to serve consumers health and social support needs — all their ongoing service needs as well as those arising from COVID-19. The second is to ensure that organizations that provide these services remain open — and survive the short-term and long-term effects of the crisis. For more resources and tips on negotiating new terms with payers and health plans, we’ve pulled together some resources from the OPEN MINDS Industry Library:
- Negotiate Those Contracts
- How To Build Value-Based Payer Partnerships: An OPEN MINDS Executive Seminar On Best Practices In Marketing, Negotiating, & Contracting With Health Plans
- Are You Negotiating (Or Gambling) With Health Plans?
- Identifying Strategic Opportunities: Cultivating, Negotiating & Decision-Making
- How To Build Value-Based Payer Partnerships: An OPEN MINDS Reading Book On Best Practices In Marketing, Negotiating, & Contracting With Health Plans
- The OPEN MINDS Health Plan Partnership Summit: A Guide To Developing & Negotiating Partnership Agreements With Health Plans
- The Keys To Negotiating Risk-Based Contracts: Advice From Centerstone’s Debbie Cagle
- Seven Opportunities to Get More From Your Current Contracts
- Working With Health Plans—The 7-Part Checklist
- Becoming A ‘Preferred’ Health Plan Partner
And for more crisis management advice, sign up for our 32-week crisis management learning collaborative and technical assistance program, Building Resiliency In The Face Of Adversity: The OPEN MINDS Executive Blueprint For Organizational Sustainability & Success In A Disrupted Health & Human Service Market. The learning collaboration – will be led by me and 15 of our key team members – will be available at no charge for elite-level OPEN MINDS Circle members- register here. And check our web site for updates, tools, and best practices for management in these trying times. If you have urgent questions, call our Circle toll-free number (877) 350-6463 or email email@example.com for assistance in locating resources.