Massachusetts Behavioral Health Partnership

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MBHP: A ValueOptions General Partnership. Contracting with Commonwealth of Massachusetts: MassHealth (Medicaid) and Dept of Mental HealthContract started: July 1, 1996230 representatives in four locales (counting three territorial offices)Provider Network:Over 250 associations (400 sites)Over 1000 individual specialists.

Presentation Transcript

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´╗┐Massachusetts Behavioral Health Partnership/ValueOptions Implementing a Clinical Outcomes Management Protocol in a Medicaid Behavioral Health Provider Network

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MBHP: A ValueOptions General Partnership Contracting with Commonwealth of Massachusetts: MassHealth (Medicaid) and Dept of Mental Health Contract started: July 1, 1996 230 workers in four destinations (counting three local workplaces) Provider Network: Over 250 associations (400+ destinations) Over 1000 individual professionals

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Overview of MBHP: Member Services 320,000 Medicaid enrollees About 100,000 utilizers, every year Process 3.2 million cases, yearly Emergency administrations though populaces Services though levels of couldn't care less: Outpatient Diversionary Acute Care

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Key Definitions Outcome Clinical change throughout treatment as measured by an institutionalized appraisal device Outcomes estimation Administering a similar evaluation device at various focuses amid treatment to quantify the rate of clinical change after some time Outcome administration Using results information to assess, educate and enhance clinical practices

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Why Measure Outcomes? Customers have a privilege to a complete admission appraisal, with intermittent re-evaluations. Treatment is enhanced when clinicians get target criticism on the clinical advance of their customers. The concentrated accumulation of results information over a supplier arrange takes into account the ID and advancement of best practices. Reports of system wide accomplishments in results permit the EOHHS organization and the lawmaking body to consider MBHP and its suppliers responsible.

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Goals the MBHP Outcomes Management Initiative Care Management Improve admission evaluations and treatment arranging through utilization of a structure results instrument. Rehearse Management Identify, advance and bolster best practices among MBHP organize suppliers. Responsibility Management Improve responsibility for openly supported behavioral wellbeing administrations.

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MBHP's Outcomes Policy (Core Principles) All system suppliers though levels of couldn't care less are required to: 1. Select an institutionalized evaluation instrument from the rundown of MBHP-endorsed instruments; 2. Start overseeing the chose instrument for every single new admission of PCC Plan MassHealth Members; 3. Consolidate the discoveries of the appraisal into the Members' treatment arranges, with criticism to Members about the evaluation results; and 4. Join the amassed discoveries of the results appraisals into the supplier's quality administration program.

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Scope of the Outcomes Policy All suppliers in the MBHP organize 250 supplier organizations (with more than 400 destinations) and 1000 individual professionals All levels of care: inpatient, outpatient, diversionary except for a couple absolved administrations, for example, solution administration, mental testing, and case counsel All Member ages Children, young people, grown-ups up to age 65 All Members are surveyed Sampling is not permitted

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Implementing the Outcomes Policy Providers can choose from 20 MBHP-upheld results instruments. Suppliers may apply for endorsement to utilize institutionalized evaluation apparatuses with great psychometric properties that are not upheld by MBHP. The Brief Psychiatric Rating Scale will be incorporated into the pre-affirmation and release convention for every one of the 24-hour intense confirmations and releases.

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MBHP Policy on Use of Outcomes Data MBHP will utilize results information as a method for offering specialized help to suppliers in regions where enhanced results is a fancied objective. MBHP won't utilize results information to oversee Member benefits. MBHP won't utilize results information as a sole marker for making disciplinary move against a supplier. MBHP will proceed, as it has, to lead quality reviews on supplier rehearses and will require remedial activities when benefit quality does not meet supplier execution determinations.

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Turning the Outcomes Initiative into a Best Practices Initiative The Central Role of Behavioral Health Laboratories' (BHL) Treatment Outcome Package (TOP)

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Selecting BHL's TOP as the MBHP Preferred Outcomes Instrument BHL's TOP is an astoundingly planned results estimation and clinical data framework. Suppliers utilizing TOP would be in prompt consistence with the MBHP results arrangement. With its unified results information gathering, MBHP's entrance to TOP information permits accomplishment of the three venture objectives: enhancing care administration, rehearse administration, and responsibility administration.

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What is Unique About TOP? Clinically rich information Strengths Separation Anxiety Eating Sexual Issues Sleep ADHD Conduct Assertiveness Depression Psychosis Accidents Suicide Violence Sensitivity to change >90% No floors or roofs Fair examinations Extensive hazard conformity Immediate STAT lab tests Largest dataset Data investigation included Exceptional bolster Toll free Toolsets Child Adolescent Adult Leading scholastics See Advisory Panel Extensive approval MA Medicaid N>250,000

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MBHP's Subsidy Arrangement for TOP MBHP is paying all expenses related with the utilization of TOP (aside from mailing and fax charges). Suppliers enroll with BHL and utilize TOP at for all intents and purposes no cost to them. As an end-result of the sponsorship, suppliers concur that MBHP will gather their results information from BHL.

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Current Status of Implementation as of March, 2004 The MBHP supplier arrange has around 250 organizations and 1000 individual professionals. 75% of the offices and 40% of the individual professionals (or half of all suppliers) have pronounced their decision of instrument. More than 470 (70%) of the announced suppliers have utilized TOP. At the point when completely operational, TOP results information will be gathered on more than 60,000 Members.

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The Power of BHL Data and Reports Client Empowerment Clinical Decision Support Clinician and Agency Accountability Clinician and Agency Quality Improvement National, State, and Agency Benchmarking Legislative Reports for Performance Accountability

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TOP 4.0 Child Outcomes Report (bring down qualities = change)

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TOP 4.0 Client Report of Stress Indicators

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TOP 4.0 Client Report of Risk Indicators

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Using BHL Benchmarked Reports to Identify Best Practice Providers BHL creates benchmarked reports that can be utilized at the organization level or system level for quality change. These benchmarked reports indicate supplier execution in accomplishing great results in respect to different suppliers. MBHP will utilize the benchmarked reports to recognize best practice suppliers and to advance their effective techniques.

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BHL's Benchmarked Reports for Provider-or Network-Level Child Practice Management Best Practice Needs Improvement

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Developments in Process Combining TOP results information with MBHP claims information to evaluate the relationship of clinical results to administration use and cost. Enhancing and growing supplier profiling reports for quality change and execution administration. Creating responsibility reports for the Commonwealth that will be a national model for execution administration.

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MBHP Contact Wayne Stelk, Ph.D., VP, Quality Management Massachusetts Behavioral Health Partnership 150 Federal Street, 3 rd Floor Boston, MA 02110 617-790-5612