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Changes in the environment

The Impact of Billing and Third Payer Participation on Your Workforce:  Lessons From the Pacesetter Award Process John Morris, M.S.W. Wayne Dailey, PhD The Annapolis Coalition NIATx Webinar May 10, 2011. Affordable Care Act: Accountable care homes Changes in block grants

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Changes in the environment

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  1. The Impact of Billing and Third Payer Participation on Your Workforce:  LessonsFrom the Pacesetter Award ProcessJohn Morris, M.S.W.Wayne Dailey, PhDThe Annapolis CoalitionNIATx WebinarMay 10, 2011

  2. Affordable Care Act: Accountable care homes Changes in block grants Changes in state and local funding strategies Changes in insurance…a resurgence of capitation and population based models Pay-for-performance Changes in the environment

  3. Response of the Fieldre: Workforce Development • Typically - delayed & minimal • Significant erosion in investment in workforce development • Universal problem irrespective of setting, discipline, or specialty • Only made worse by complications of billing requirements, licensure, credentialing, etc.

  4. What is The Annapolis Coalition? • A small not-for-profit • Large “Coalition” • Neutral convener of stakeholders • Source of information & technical assistance • Vehicle for strategic planning, collective action, & public/private partnerships

  5. Best known for…National Action Plan • Two years & 5,000 participants • Federally funded • Mental health & addictions • Treatment & prevention • Seeking to identify: • A core set of strategic goals & objectives • High priority ACTION items by stakeholder • A planning resource • Call to action

  6. Behavioral Health Pacesetter Award: Purpose • Discover and analyze emerging workforce best practices • Focus on: • Community-based care • Direct-care workers • Unlicensed • Bachelor's degree or less

  7. Hitachi and Annapolis • A partnership built on a focus on workforce • A concern about the front-line workforce as especially vulnerable • A desire to showcase ideas that demonstrate • Better Jobs • Better Services • Better Business

  8. Who are these Direct-care Workers? Estimated: 40% of Community Behavioral Health Workforce

  9. Offered: Low pay Little training and supervision Poorly defined career path Little respect from licensed behavioral health professionals Scant access to information technologies Asked to: Care for people with the most complex conditions Work in neighborhoods that lack resources Take personal risks What are their historical challenges?

  10. What do they have to offer? • Role models for recovery • Understanding of mental illness and substance abuse • Connection with neighborhoods and diverse racial/cultural communities

  11. Pacesetter Award: Objectives • Identify practices that have: • On the business/employer, AND • On the lower wageemployee, AND • On the client

  12. Five Selection Criteria Significance Effectiveness Novelty Durability Transferability

  13. Pacesetter Award: Process • Announcement (February 2010) • “Call for Nominations” (March 31st) • Applications due (May 15th) • Review teams established (June) • Eligibility determination (June) • Teams conduct reviews (July-Sept) • Initial sorting with The Hitachi Foundation (October) • Case study development (Oct-April) • Announce Awards (April 2011) • Dissemination of results (Spring/Summer 2011)

  14. The National Winners!! • Thresholds in Chicago used “embedded consultants” and supportive supervision to advance careers of front-line mental health staff and implement Integrated Dual Disorders Treatment. • Stanley Street Treatment and Resources (SSTAR) in Fall River, MA used “work-based learning” to change the competencies and educational aspirations of its behavioral health staff. • Family Services of Western Pennsylvania in Pittsburghbuilt university and county government partnerships that transformed case management and promoted careers of front-line staff. • Borinquen Health Care Center in Miami prepared its multicultural substance abuse and community outreach workers to battle the spread of HIV on the city’s streets. • Hartford Dispensary in Connecticut built a professional development program that meets the challenges of direct-care staff as they provide effective treatment for heroin addiction.

  15. Programs of Merit • Chesapeake Connections at Mosaic Community Services inBaltimore prepared a diverse staff group to provide assertive yet supportive services to people with severe mental illnesses. • People Acting to Help (PATH) in Philadelphia made thoughtful and supportive supervision the heart of an effective psychosocial rehabilitation program

  16. Healthcare environment in influx Affordable Care Act - ACA Medicaid Block grants State and local budget cuts Implications for workforce Recruitment Training Deployment The impact of financing

  17. Thresholds, Chicago • Switch from grants to fee-for-service funding • Changes to internal agency operations: • Productivity goal setting and monitoring • Changes in training methods • Use of embedded consultants • Emphasis on technologies • Financial incentives • Recruitment implications Debbie Pavick Acting CEO Dennis Crosby Team Leader at Irving Park “L” station in Chicago

  18. Jeff Richardson, CEO Mosaic Community Services Mosaic’s Chesapeake Connections, Baltimore • Merger Mania • Capitation Pilot Project • PM/PM rate • Financial risk • Training implications • “Anything it takes” • Non-traditional interventions • Team, Team, Team • Recruitment • Based on matching staff with members Former North Baltimore Center

  19. Few credentialed staff Limited access to care & reduced growth potential Workforce with limited educational preparation Reduced volume of billable services & less revenue Lower salaries & more staff recruitment problems SSTAR - Fall River, MAStanley Street Treatment and Resources Circular Dilemma

  20. SSTAR - Fall River, MAStanley Street Treatment and Resources Impact of Work-based Learning funded byJobs to Careers Initiative

  21. Lessons Learned • Payment type influenced selection, training and deployment of direct care workers • Biggest differences between: • Fee for Service • Productivity and efficiency • Capitated program • Creativity, improved client outcomes and managing cost risk

  22. 2011 National Winner Behavioral Health Pacesetter Award Pacesetter Award Winning Programs • Used EBPs and maintained fidelity • Supported worker education and career aspirations • Provided competitive compensation • Established links with academic and research institutions • Provided supervision to staff on a frequent, regular basis

  23. Annapolis Coalition on the Behavioral Health Workforce www.annapoliscoalition.org John Morris, M.S.W. Executive Director jmorris@tacinc.org Wayne F. Dailey, PhD Project Coordinator waynedailiey7@gmail.com

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