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Arizona BH Payment Reform ToolkitProvider Readiness Self-Assessment

Orientations: March 16 and 18

Dale Jarvis, CPAKaren Linkins, PhDJennifer Brya, MA, MPP

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Format for Today’s Webinar• I will walk through slides and jump in and out

of Survey Monkey.• If you have questions:– Type in a question in the

Questions dialog box– And Press Send

• You can also RaiseYour Hand if you wantYour question answeredASAP.

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If the Webinar Dialog Box…

• Is covering too much of your screen

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If the Webinar Dialog Box…

• Press theRed Arrow

• To Minimizethe Dialog Box

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Now, on to the Orientation…

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What we learned at the Boot Camp1. Change is coming to the

Arizona behavioral health system.

2. Payment reform readiness preparation needs to begin now.

3. A Provider Readiness Self-Assessment and Key Informant Interviews with RBHAs and the State are the next steps in the process.

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What we learned at the Boot Camp4. We think the

Arizona public behavioral health system of care will benefit from moving into payment reform in four phases.

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What we learned at the Boot Camp5. We think the RBHAs and Behavioral Health

Providers have 2 to 3 years to demonstrate that they can accelerate movement toward the triple aim for Medicaid enrollees with BH disorders.

6. Otherwise, some portion of the ecosystem may be….

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Phase 1 – Payment Reform Preparation

• Key Questions– What readiness gaps do the provider organizations need to

close to succeed in Phase 1?– What readiness gaps do the RBHAs need to close to succeed

in Phase 1?– Which parts of the work should be cross-RBHA efforts and

which belong inside each RBHA?

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Phases 2 – 4 • Will roll out on a yet-to-be determined

timeline.• Likely over the next 1-3 years.

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The Provider Readiness Assessment

• 8 Areas• 40 Questions• 5 “Station

Breaks”• To tease out

your strengths and areas that you need to beef up

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What You Need to Do…Step 1: Identify a lead for this mini-project.Step 2: The lead reviews the survey and decides who should be on the ad hoc team to complete the self-assessment (1 hour).Step 3: Give the survey to each person on the ad hoc team and have them read it (30 minutes per person).Step 4: Meet as a small groups to answer as many questions as possible and determine homework assignments to answer the rest of the questions (1-2 hour meeting).Step 5: Everyone complete their homework (1 hour per person).Step 6: Meet a second time as a group to finish the answers and do a final review (1 hour meeting).Step 7: Enter the answers into Survey Monkey (20 minutes).

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Important Note about Step 7• Survey Monkey is a great tool but has one quirk.• Once you begin entering information into the

Survey Monkey, you have to finish entering all responses. You cannot enter some of the responses and come back later to finish your entries.

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8 SectionsSection A: General InformationSection B: Client Needs and Caseload ManagementSection C: Access, Scheduling, and EngagementSection D. Clinical Practices and Outcomes Based CareSection E: Integrated Care and Care CoordinationSection F: Business PracticesSection G: Information Technology QuestionnaireSection H: Regulatory Requirements Burden

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What about the RBHAs and the State• We will be conducting key informant

interviews with each RBHA and key folks from the state to gather additional information, including:– RBHA Readiness in key areas– What Value-Based Purchasing ideas RBHAs

are already working on– Where RBHAs think they should work

together on a single design for a particular part of the system

– What are the key value-based purchasing components the state would like to see moved forward

– How can this effort support the SIM Grant

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Let’s Look at a Station BreakStation Break – Level of Care System

• Payment reform requires patients/clients to be tagged with a clinical cohort in order to compare quality and efficiency in an “apples to apples” manner. For example, those studying the medical care system would never mix people receiving a knee replacement and people having heart surgery into the same quality and efficiency study.

• This is more nuanced, but equally important for those with behavioral health disorders. It is not appropriate to mix adults with mild to moderate depression into the same study with adults with a serious and persistent mental illness who are being admitted to a psychiatric hospital more than twice per year.

• The behavioral health solution, which is being widely adopted throughout the country, is to develop and agree upon a standardized Level of Care System with clear Authorization Criteria, and Utilization Management Guidelines. This clinical cohort framework moves beyond diagnosis, adding other dimensions such as Risk, Functional Status, Co-Morbidity, and Recovery Environment.

• Without Behavioral Health Levels of Care, it will be extremely difficult to move to value-based purchasing.

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Let’s Jump Over to Survey Monkey

• https://www.surveymonkey.com/s/WYYMX2H

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There’s Also a Hard Copy Version

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IMPORTANT!!!• All Survey Monkey submissions are CONFIDENTIAL.• We will compile the results, labeling them Agency 1,

Agency 2, Agency 3, etc.• The Agency Names go into a BLACK BOX and will not be

shared outside the consulting team.

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Next Steps• Monday and Wednesday Orientations (3/16, 3/18).• Friday 3/20: Email to All Providers containing:

– These Slides– 18 Page hard copy Readiness Assessment– Link to Survey Monkey electronic Readiness Assessment

• Two Weeks to Work on the Assessment (March 23 – April 3); the submission deadline is April 3, 5pm.

• Your consulting team will compile the results (April 6-10).• Two webinars (repeats) April 14 and April 15 to share Results.• Two outcomes of the results:

– The Providers, RBHAs and the State will have important information on the readiness efforts needed to succeed with payment reform.

– Your Consultants will determine where to go DEEP with Toolkit Information.

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Questions?• Monday and Wednesday Orientations

(3/16, 3/18).• Friday 3/20: Email to All Providers

containing:– These Slides– 18 Page hard copy Readiness Assessment– Link to Survey Monkey electronic

Readiness Assessment

• Two Weeks to Work on the Assessment (March 23 – April 3); the submission deadline is April 3, 5pm.

• Your consulting team will compile the results (April 6-10).

• Two webinars (repeats) April 14 and April 15 to share Results.

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After Today…• If you have ANY QUESTIONS, please contact:– John Freeman: john@djconsult.net– Bahney Dedolph: bdedolph@azcouncil.com

• If you need ANY HELP, please contact:– John Freeman: john@djconsult.net– Bahney Dedolph: bdedolph@azcouncil.com