We’ve written before about the many new types of services and contracts that are growth options for specialty provider organizations. There are value-based reimbursement contracts (see Developing Case Rates? Better Find Your ‘Single Source Of Truth’ and VBR @ Scale—Changes Required), virtual health opportunities (see Virtual Mental Health Delivery Systems Evolve and Virtual Health As Strategy—Starting With Telehealth), and subscription health services (see Should Your Organization Sell Health Care Subscriptions? and You Say Subscription-Based Health Care, I Hear Customer Service).
One of the many challenges when new opportunities arrive is selecting, acquiring, and implementing new technologies required for success. In a recent presentation at The 2019 OPEN MINDS Performance Management Institute session, Data Sharing & Reporting In A Value-Based Market: Adapting To Ever Changing Reporting Requirements While Enhancing Your Own Organization’s Performance, Larry Allen, Chief Operating Officer of Central Florida Behavioral Health Network (CFBHN); Tom Rose, Director of IT of CFBHN; and Katie Morrow, Vice President of Compliance of Streamline Healthcare Solutions, shared their experiences in how to create an enhanced technology infrastructure to meet the needs of new market opportunities.
CFBHN won the Florida Department of Children and Families’ (DCF) first Managing Entity contract in June 2010. Under the Managing Entity model, all contracting for community-based mental health, substance abuse, and substance abuse prevention services with local provider organizations is facilitated through the Managing Entity (see Central Florida Behavioral Health Public Behavioral Contract Renewed For Almost $1 Billion). The Managing Entities provide safety net services to the uninsured population and wrap around services for Medicaid populations for services not covered by Medicaid managed care plans. Currently, CFBHN is the Managing Entity for public substance abuse and mental health (SAMH) services in 14 counties.
In 2015, the Florida DCF developed the Financial and Services Accountability Management System (FASAMS), a state-run information management and accounting system for organizations providing community-based mental health and substance abuse services. The new state system is built off the Web Infrastructure for Treatment Services (WITS) platform, an open source, web-based system that collects and reports clinical, outcome, and administrative data for behavioral health. In collaboration with the state, CFBHN works with their provider organizations to share data, which is then put into the state system. Currently, there isn’t full, two-way sharing of all data back and forth between the state and the managing entities, but this system has enabled greater data sharing across the entire state system of care.
As the Managing Entity, the consumers’ CFBHN serves are engaged in multiple systems; this demands the integration of data from multiple sources—county Sheriff, Medicaid health plans, school system, county housing authority, etc. Some of these entities are willing to share information, while others have been unable or unwilling. CFBHN has worked with entities throughout the system and the state to gain access to more information wherever possible to create a bigger data picture of the population. This allows all stakeholders to see the issues and costs, and then target the consumers who are high utilizers.
In the session, they shared four key elements in successfully conceptualizing and developing their technology needs to build a more data-focused comprehensive system of care. Those key elements include:
Focus on workflow and streamlining processes—To improve workflow and enable their provider network to better share data, CFBHN engaged in a search process to identify community electronic health record (EHR) systems that would enable greater coordination and data sharing. Their search focused on functionality, innovative use of technology, the ability to manage multiple payment methodologies, and costs (both implementation and ongoing). They partnered with two EHR vendors—Streamline and Adaptive Infotech— and leveraged their provider partner network to get group pricing. (However, provider organizations are not required to use either of these EHRs.) This consistency helped to streamline workflows and processes, which enhanced CFBHN’s ability to share data.
Consider the implications of changing reimbursement and performance requirements in the design process—Managing Entities are paid a set monthly amount by the state for direct services, but are not fully at-risk. CFBHN contracts with provider organizations for the delivery of services using multiple payment methodologies. Working with multiple payers and a state system that changes requirements on performance and outcomes has demonstrated the need to be adaptable. The current system requires organizations to understand how to correctly bill and record revenue in a way that lets an organization master new billing requirements, while keeping costs down and correctly budgeting.
Be adaptable—In a system of care where provider organizations are working with multiple payers and state systems can change course on reporting requirements and reimbursement methodologies, it is important to be adaptable and anticipate changes. Provider organizations will need flexibility around methods for recording information, and have the ability to adapt claims to meet individual payer needs.
Leverage the data that you collect—Don’t collect just for the sake of collection. It is important to review all the data points that you are collecting and to make sure they add value. Once you have a usable data, its essential to make it available to all stakeholders in a timely manner and with enough detail so that the data points can be understood. Being transparent about data collection processes, maintaining consistency with reporting, and providing education on how to use the data will ensure that the data adds value. Data that isn’t shared is data that isn’t used.
For more on using data to improve your organization’s performance, check out these resources in the OPEN MINDS Industry Resource Library:
- Building & Executing Strategy In A Complex Market-A Three-Phase Best Practice Model For Success
- Make Your Data ‘Count’
- Getting More From Your EHR
- Metrics-Based Management For Value-Based Reimbursement
- The Missing Numbers
- Navigating By The Numbers-The Market Metrics Shaping The Complex Consumer Market
- Structuring (& Budgeting For) Analytics
- Data Sharing To Enable Population Health Management
- Is Your Staff ‘Performance Prepared’?
- 3 Steps To Leading A Digital Transformation In Your Organization
For more from Streamline, check out The Importance Of Coordinating Data In Behavioral Health Under A Value-Based Model. And for more on data and tech in the health and human services space, mark your calendar for The 2019 OPEN MINDS Technology & Informatics Institute in Philadelphia on October 28 to October 30.