Providers Growingly Concerned About EHR Functionalities & The Technologies Needs For Future Service Delivery & Reimbursement: Top EHR Trends From The 2021 OPEN MINDS National Behavioral Health EHR Survey

Originally presented on October 19, 2021.

We’re bombarded with stories about electronic health records (EHR) evolving to become more flexible and use more services like blockchain, cryptocurrencies, and artificial intelligence, but what do your peers report firsthand? We recently concluded the sixth annual OPEN MINDS National Behavioral Health EHR Survey and found that 53% of provider organizations report their EHR does not have all the functionalities they need. Only 19% report their clinical, scheduling, billing, and reporting and analytics functionalities as meeting their needs. These Core 4 functionalities are crucial to service delivery and organizational sustainability.

In this webinar, OPEN MINDS Senior Associate, Joe Naughton-Travers, shared the results of the 2021 OPEN MINDS National Behavioral Health EHR Survey and discussed what organizations can do to plan for the next advances in health care technology and service delivery. Mr. Travers also discussed the growing concern among providers and what functionalities to be looking at for future service delivery and timely reimbursements.

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Top 6 Best Practices For Staying Human While Keeping Your Distance

One of the major developments of the COVID-19 pandemic has been the phenomenal growth of telehealth use, especially in behavioral health care. Telehealth became ubiquitous during the pandemic, and it is predicted that a large percentage of health care will continue via telehealth even after the public health emergency eases. A recent survey by Qualifacts and the National Council for Behavioral Health found that:

  • Before the pandemic, telehealth utilization in behavioral health care was relatively low, with only 2% of organizations providing 80% or more of their care virtually (See COVID-19 and Value-Based Reimbursement: What Do We Know? Where Will it Go?).
  • At the height of the pandemic, 60% of behavioral health organizations were providing 80% or more of their care virtually – due to policy changes reducing barriers to telehealth.
  • A majority of behavioral health care executives expect the increased utilization of virtual services to continue, with an estimated 40% to 60% of their overall services being provided via virtual platforms (See The New Role of Virtual Care in Behavioral Health).

Before 2020, health care was poised to start using more technology to allow consumers to make appointments, share records, and connect with their clinical professionals electronically. However, COVID-19 forced the rapid adoption of many of these services, particularly telehealth (See 21st Century Cures Act Paves The Way For Telehealth To Bloom During Pandemic). It turns out, consumers appreciate the ease of telehealth, especially because it allows them to avoid traffic and waiting rooms. Clinical professionals have also benefited from telehealth, finding that it allows them to see how their consumers are living day-to-day. Another advantage of telehealth is the ability to reduce barriers to care, such as time away from work and the stigma associated with seeking care (See What You Should Be Thinking About Now).

Mental health services were among the quickest health care specialty to switch to online treatment. With data collected between November 2020 through February 2021, 33% of all mental health appointments were conducted virtually. Primary care followed behind, holding 17% of its visits virtually. Pediatrics held 9% of its visits virtually, cardiology 7%, and OB/GYN visits were at 4%.

But despite the popularity and advantages of telehealth, clinical professionals must recognize that telehealth does not work for all consumers and all conditions. Regardless of age, many individuals are uncomfortable using technology, especially for sharing private health information. Also, not all consumers have access to high-speed internet, and therefore must resort to telephone appointments when an in-person visit is not an option. Above all, clinical professionals need to deliver the same personal, human interaction over the internet or the phone as they do in person. To ensure your clinical staff are maintaining a high quality of care without losing the personal touch while virtual, be sure to follow these key best practices:

  1. Establish a baseline for in-person versus virtual visits. Take a hard look at your service lines and consumer populations, as well as any payer requirements, when considering how often to require in-person versus virtual visits once the current pandemic ends. Even if your consumers love telehealth, make sure requirements are clear on how frequently they should be seeing consumers in-person — such as once every four telehealth visits — or whatever is determined to be best for your organization, clinical professionals, and payers. Advise your staff to be up front with consumers about the in-person/telehealth requirements from the office. Many people have anxiety as the world re-opens, and it is best to give people advanced notice of plans and expectations for future meetings.
  2. Acknowledge previous statements. Just like in an in-person visit, encourage your clinical professionals to spend a moment to chat with their consumers, perhaps following up and checking in on what you discussed in your last visit to make sure you both understand where you left off. This also works for clinical professionals as they move from topic to topic during consultations – spending a moment to reiterate an earlier conversation confirms you’re both on the same page. This helps the conversation stay on topic and helps your consumers build a connection with their clinical professionals, even if they have only ever met virtually.
  3. Listen to your consumers. As the world starts to re-open, advise your clinical professionals to check in with their consumers to see whether they would like to continue virtually, start meeting in-person again, or some combination of the two. Staff should realize it is also important to acknowledge any frustrations consumers may have regarding the platform or anything else in their lives. Even during a virtual appointment, it is obvious if someone is upset by the tone of their voice. Acknowledging these frustrations will demonstrate to consumers that their clinical professionals are present, even if they are not physically in the same room. This person-centered care approach will help your consumers feel more connected to their clinical professionals and actively involved in their treatment, which can positively impact health outcomes.
  4. Different policies for different diagnoses. As an office policy, it is also important to think about the consumer diagnoses your organization handles to see what works well digitally. Some treatment plans focusing on talk therapy may lend themselves naturally to telehealth, while others requiring injections or blood samples must be conducted in person. Think through the consumer population your organization treats and set some guidelines for your clinical professionals about how they should plan to handle future visits. For example, children being treated for attention deficit hyperactivity disorder (ADHD) are typically weighed to make sure they are not losing weight due to appetite loss from medication. Set a policy for parents to weigh children at home or develop a schedule for in-person visits.
  5. Explain the technology. All these tech tools are great, so long as everyone can use them. As an organization, be prepared to offer some training to your staff on how to effectively use technologies. If consumers are intimidated by a patient portal, they may be too shy to continue with treatments. It is important for your staff to be respectful of consumer’s tech knowledge and offer guidance without being condescending. Depending on your practice, you could even designate someone in the office to handle tech support for all consumers. Whatever you decide–just make sure you have someone available and willing to reach the consumers where they are.
  6. Do not be afraid to ask questions. Even on a virtual visit, your staff must be able to talk with consumers and engage with them as they would in person. Encourage your staff to make simple small talk to start a conversation, such as commenting about the weather or compliment a new hair style. Even in a virtual world, consumers need to feel connected to clinical professionals, so it is important to show attention to the consumer’s person. Teach your staff basic techniques to recenter and engage again with the conversation should their focus wane briefly.

As the world and industry change and we approach the next normal, provider organizations must embrace the fact that virtual care is here to stay. Incorporating a person-centered approach to care is incredibly important during these times when most of our care is being delivered virtually. To learn more about person-centered care and how to keep your consumers actively engaged in their own health care, view this recent archived webinar, A Stable Connection Should Mean More Than Just a Strong Wi-Fi Signal: How to Keep Care Connections Personal in a Virtual World.

The full text of “athenahealth Creates Online Telehealth Insights Dashboard to Help Practices Benchmark Their Performance and Find Opportunities to Better Meet Provider and Patient Needs” was published March 9, 2021, by athenahealth, Inc. A free copy of this and access to the Telehealth Insights Dashboard are available online at https://www.businesswire.com/news/home/20210309005235/en/athenahealth-Creates-Online-Telehealth-Insights-Dashboard-to-Help-Practices-Benchmark-Their-Performance-and-Find-Opportunities-to-Better-Meet-Provider-and-Patient-Needs (accessed July 23, 2021).
The full text of “Help patients adjust to telehealth by remembering the human touch” was published June 23, 2020, by the American Medical Association. A free copy is available online at https://www.ama-assn.org/practice-management/digital/help-patients-adjust-telehealth-remembering-human-touch (accessed July 12, 2021).

Going Hybrid? Charge Your EVV

By Monica E. Oss

If your organization is one of many that is thinking about moving to a hybrid service delivery model—virtual, in-clinic and in-home—your team will need to learn more about electronic visit verification (EVV). EVV was mandated for all home-based services by the 21st Century Cures Act, passed in 2016. The act required all state Medicaid programs to start using EVV for personal care services (PCS) by January 1, 2020 and for home health care services (HHCS) by January 1, 2023. EVV is essentially electronic verification that in-home service encounters actually occur and documents the type of service performed, the individuals providing and receiving the service, the date and location of the service, and the time the service begins and ends.

For PCS, many states applied to the Centers for Medicare and Medicaid (CMS) for “good faith exemptions” and received an extension until January 1, 2021. States are in different stages of implementation and some already require EVV for HHCS as well (see What Are The EVV Compliance Rules In Your State?) States that don’t implement EVV will have to take a cut in their annual federal medical assistance percentage (FMAP) starting at 0.25 percentage points and gradually increasing to one percentage point (see States Must Use Electronic Visit Verification By January 1, 2020 For Medicaid Personal Care Services).

EVV is required for all Medicaid covered in-home visits for personal care and health care services including nursing; home health aide services; and medical supplies, equipment, and appliances that are delivered via an in-home visit under the state’s home health benefit. States also may choose to require EVV for in-home physical therapy, occupational therapy, speech pathology, audiology, and other services (see Frequently Asked Questions: Section 12006 Of The 21st Century Cures Act). CMS does not require EVV in some instances—when the caregiver and consumer live together, for congregate facilities offering 24-hour services, or for Programs of All-inclusive Care for the Elderly (PACE)—although individual states may mandate otherwise.

While EVV does not specifically track consumers and staff, it does require multiple check-ins by staff at specified times with location identification—through a smartphone app with GPS tracking, the use of a landline phone in the consumer’s home, or signing into a device in the consumer’s home. For provider organizations required to comply with EVV mandates, the level of investment depends on the model chosen by their state. States have five options—an open model where provider organizations use their own EVV systems; EVV systems mandated by health plans; a single statewide vendor to be used by all provider organizations; build and manage a state-owned EVV system; or allow provider organizations to opt to use the state system or their own EVV system compatible with the state’s data aggregator (see EVV Systems Section 1: Requirements, Implementation, Considerations, & State Survey Results).

While the intent of EVV is to avoid fraud and ensure that consumers get the services they are supposed to get, there is widespread concern by consumers and advocacy groups on the practical challenges and alleged threats. For example, caregivers in Arkansas have complained about glitches in the state-mandated EVV app that have resulted in missed service entries and delayed paychecks. The Arkansas compliance requirements also have been criticized for placing undue burden on on live-in caregivers and on self-directed consumers who hire their caregivers directly and manage their own services. And some stakeholders do not like the sense of “constant surveillance.” Consumers complained that having an EVV system was comparable to having a wireless dog fence or ankle monitor (see ‘We Don’t Deserve This’: New App Places US Caregivers Under Digital Surveillance).

Other concerns have been expressed about the EVV impact on consumers—the Arc describes it as a “civil rights issue because of the concern around unintended consequences of impeding upon an individual’s privacy rights.” EVV systems that have video and audio recording functionalities and geotracking are not acceptable (see Call For Electronic Visit Verification Delay Grows Strong Nationwide). The National Council on Independent Living decried EVV for being “based on the archaic and offensive idea that disabled people and seniors are unable to leave their homes.” They criticized EVV for requiring multiple check-ins a day from the same location, for geotracking, and for imposing additional burdens on states (see NCIL Position Opposing Electronic Visit Verification).

What are the implications of EVV for specialty health and human service provider organizations offering home-based services? There are a few big issues to contend with—adopting new technology, creating new service delivery workflows, revising policies and procedures, training staff, and educating consumers and obtaining their input. OPEN MINDS Senior Associate Jason Lippman said, “EVV plays into a lot of digital trends we are seeing all around us—requirements for more data and more accountability. And the systems that work as intended can provide more data for planning and management of resources. The key is designing systems to collect that data that are least intrusive for both consumers and staff, creating efficiencies, and mitigating for unintended consequences and privacy issues.”

Like the EHR requirements of the past decades, the requirements for documentation of services delivered in home-based settings are likely not going to go away. And, it is likely that the EVV requirements will prove to be another factor—like value-based care, interoperability requirements, and hybrid service delivery models and ecosystems—that put larger organizations with better technology planning competencies at an advantage. Mr. Lippman pointed out, “As we gear up for 2023 and wait for the HHCS provisions around EVV to kick in, provider organizations should not put off being prepared—now is the time to start looking into what the state is currently doing with PCS, and to initiate the infrastructural and operational changes that will be required to accommodate digital tracking of remote services.”

For more on EVV preparation and management, check out these resources in The OPEN MINDS Circle Library:

Don’t Leave Money On The Table: How The Right Technology Can Improve Your VBR Success

Originally presented on May 26th, 2021

Value-based care is here! If you haven’t started thinking about what it is you need to compete in a value-based environment, now is the time to start. With the rise in value-based care contracts and utilization of alternative payment models, provider organizations are challenged with doing the research and homework to get prepared for these new ways of managing care.

Hear an update on where we are with value-based care from OPEN MINDS Senior Associate, Ken Carr, as well as a firsthand case study from Capital Area Human Services (CAHS) on their journey to value-based care. CAHS Director of Business Development, Karla Lee Muzik, and Program Manager, John Nosacka, will showcase how their organization discovered they had been losing money by not having the right technology and how they began to remedy the problem.

During this session, attendees will:

  • Understand the current state of value-based care
  • Discover how to tell if they too are losing money with the wrong tools and technology
  • Hear a real-life case study from one provider organization who was losing money by not having the right tools to succeed with value-based contracting

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Value-Based Reimbursement Models Help SPARC Get A Leg Up In Medicaid Managed Care Contracting

By Meena Dayak

SPARC Services & Programs (SPARC) is a behavioral health provider organization in North Carolina that has been providing home and community-based services since 2015. They serve 425 consumers monthly and employ 70 full-time staff. They focus on complex consumers—children and adults with severe and persistent mental illnesses (SPMI) who have not been successful with residential and other traditional treatment services—and work to keep them out of institutional care. Currently, most of their consumers are covered by Medicaid, although they have just started to expand into the commercial insurance space. SPARC’s service array includes outpatient services, home and community-based therapy services, rehabilitation services to help consumers transition from residential treatment to community living, support for daily living activities to help consumers live independently in the community, case management, and enhanced crisis response.

Since its inception, SPARC has operated predominantly through value-based reimbursement (VBR) arrangements with managed care organizations. SPARC’s Co-Founder and Chief Executive Officer, Teri Herrmann, MA, talked to OPEN MINDS about their VBR models and how they have helped to advance the mission of SPARC.

Reimbursement Models

SPARC currently has two VBR contracts with two managed care organizations (MCOs), Cardinal Innovations and Partners Behavioral Health Management. 26% of their consumers receive services under these VBR models, which constitute nearly 48% of SPARC’s total revenue.

Both of SPARC’s VBR contracts are based on per member per month (PMPM) case rates. When a consumer is referred to them, they do an assessment and seek initial authorization for treatment from the health plan. Typically they get a 6-month authorization and bill one unit per month. The case rates range from $2,800 to $3,000 per month.

SPARC’s very first health plan contract with Cardinal Innovations in 2015—for children’s services—was a value-based contract with downside risk. If a child receiving Family Centered Treatment® (FCT) services from SPARC entered into residential care either during the course of treatment or up to a year post-treatment, then SPARC had to give money back to the payer. “It was pretty unheard of in that landscape,” said Ms. Herrmann. After a year, SPARC re-evaluated the contract with the payer and decided that the goal was “too aggressive.” They re-negotiated the contract to make payback contingent on no readmissions within six months of treatment. The health plan was flexible with value-based contracting as it was new territory for them, too, said Ms. Herrmann. So now, if during treatment, or up to six months post-treatment, the consumer enters into residential care or stays in an inpatient setting longer than 10 days, then SPARC is charged back up to 30% of the amount that they have billed. Ms. Herrmann noted that they’ve had to pay monies back to their health plan, especially because the consumers they serve are so complex but SPARC remains committed to value-based contracting because of the longer term potential for revenue growth and the flexibility offered by the model to improve the quality of care.

In a second value-based contract with Partners Behavioral Health, SPARC has an incentive-based payment with upside risk only for children in FCT. If the children—who receive home and community based services from SPARC—are able to remain at home three months and six months after discharge from a residential facility, then SPARC receives incentives.

For one year, SPARC also had a value-based contract with Cardinal Innovations (operating under a North Carolina Department of Justice mandate) to help adults with SPMI—who had been “inappropriately placed” in adult care homes—transition to independent living in the community. This was a value-based contract with upside risk only, where SPARC was rewarded if they could help consumers transition successfully from the adult care homes and keep them in community housing through continuous interventions.

Success Factors For Value-Based Reimbursement

Ms. Herrmann attributes the success of value-based reimbursement to four factors—a strong referral network, the use of evidence-based practices in treatment, robust data integration and reporting capabilities, and a mindset of innovation and risk tolerance.

Value-based reimbursement—and the “willingness to take on consumers that no one else wants”—has strengthened SPARC’s status as a “preferred provider” with health plans and other state entities. They receive referrals from their MCOs, local hospital systems, state social services and juvenile justice departments, residential treatment facilities, and community-based provider organizations. Ms. Herrmann said, “We’ve got a pretty sophisticated referral process that tracks all our referral sources, and then aligns them with the payers. We can see what’s working and see where the holes are so we can put a referral marketing plan in place to address the gaps.” In addition, 85% of referral sources reported that SPARC kept them informed of the status of their referral. This “closed loop” referral approach strengthens SPARC’s appeal in helping to maintain continuity of care.

SPARC was built on the foundation of the family-centered treatment (FCT) model, an evidence-based practice (EBP) with a trauma treatment model of home-based family therapy that Ms. Hermann was involved in developing in the early 2000s. She underscored that using FCT helped to achieve the improved outcomes that value-based models demand. The use of EBPs is accompanied by relevant training and certification for staff using the model, which replaces some of the prior mandated state training that was not always relevant to the services staff delivered.

Ms. Herrmann describes herself as a “data nerd” focused on assimilating and continuously monitoring outcomes data to examine the potential to improve services. She said, “We don’t just want to measure if the person showed up. We want to objectively look at each person and if they are getting better.” They have built their electronic health record system to produce the key data and desired reports and are continuously working with their developers to manipulate and learn from the data. SPARC applies this data-informed approach across their value-based as well as fee-for-service programs so they can improve performance all around. Ms. Herrmann noted that the health plans are primarily looking for data on avoidance of emergency department utilization and avoidance of inpatient services or residential care for the consumers that SPARC serves. She said, “We’ve had a pretty long placement culture here in North Carolina that we’re slowly changing the tide on. If someone really needs those more acute levels of care, there is a place in the continuum for them. But we don’t want those services to be overutilized for the wrong reasons. And so that’s where we’re really focused for outcomes measurement right now.”

SPARC was proactive from the outset and proposed value-based contracting to their health plans. Ms. Herrmann elaborated, “As we were brainstorming and envisioning the concept for this company, we wanted to serve those niche individuals whose needs weren’t being met. And we were hearing from stakeholders and payers that they were really struggling to figure out what services to get to them. So we saw that we had to be innovative. We knew that starting a company and immediately jumping into value-based contracts was a little risky. But we also knew it would say a lot about us. As a new provider organization, we said to the health plans, ‘Let’s take this walk in value-based work together and learn.’ And this pitch for risk-based contracting opened doors that may not otherwise have been opened.”

Services & Outcomes

For 2019, SPARC reported the following outcomes from its range of services covered by value-based contracts (see SPARC Services & Programs: 2019 NC Outcome Data).

Family-Centered Treatment: Family-centered treatment (FCT) is an evidence-based practice with four phases of treatment—joining and assessment, restructuring, valuing changes, and generalization. FCT is targeted toward consumers at risk for higher levels of residential service—those with extensive histories of using acute services without successful outcomes; those who’ve been hospitalized with little prior treatment and are being recommended for residential services; and those currently in residential treatment where discharge is delayed because of lack of family systems.

Services are intensive with a minimum of 10 hours per month provided to the family. FCT incorporates trauma treatment and coordination with other systems, such as the school, justice, primary care, and social service systems as well as 24/7/365 crisis intervention services. FCT seeks to confirm and capitalize on internal changes within the family so that the family is not dependent on the therapist once services terminate. Families also have the opportunity to give back to their communities and share what they have learned with other families.

While starting FCT at SPARC, 57% of referrals were in some form of an out-of-home placement and 43% were at home with their family. After treatment, 81% of consumers receiving FCT were able to remain with or be reunified in the community with their family or another caregiver. 100% of families were engaged in treatment, participating in five or more sessions in 30 days. And 96% of families reported that treatment improved their family life.

In-Home Therapy Services: In-home therapy services (IHTS) is a combination of motivational interviewing and care coordination provided in the home and community to children and their families where there are complex clinical needs that traditional outpatient therapy cannot adequately address. IHTS is a time limited service, approximately 6 months, in which a therapist and the case manager work with the child and their family to meet the therapeutic needs as well as provide linkage to professional and natural supports. The case manager works with the various systems involved with the child and family, such as the school, primary care, social services, and justice systems. Upon discharge from IHTS, children and their families can continue to receive outpatient therapy to ensure continuity of care.

85% of families successfully completed treatment and 97% of consumers were either at home with family, or in other family placements, at the time of discharge from treatment.

Transition management services: Transition management services (TMS) is a rehabilitative service intended to increase and restore a consumer’s ability to live successfully in the community by maintaining tenancy in community housing. TMS increases the consumer’s ability to live as independently as possible, managing their illness, and reestablishing their community roles related to emotional, social safety, housing, medical and health, educational, vocational, and legal services. TMS provides structured rehabilitative interventions and works in partnership with the individual’s behavioral health service provider.

90% of members participating in services were able to both obtain and maintain their housing in 2019. Only 5% were discharged from the program because they needed a higher level of care. And the program is working with 98% of consumers are on four or more social determinants of health in addition to their housing needs.

Enhanced crisis response: The enhanced crisis response (ECR) service is intended to put supports in place as quickly as possible for youth with behavioral health needs that are at risk for abandonment, crisis episodes, or being placed in restrictive levels of care. With timely assessments and supports, ECR is intended to keep youth in their environment—such as non-therapeutic foster homes, kinship placements—or minimize needs for long stays in residential treatment. Services last 60 to 90 days on average. SPARC staff work with consumers and families to diffuse the imminent crisis and get the family linked to appropriate community-based services that allow the consumer to thrive and meet their goals.

71% of youth who were discharged from the program in 2019 were able to be discharged into the community with community-based services.

Overall, SPARC’s services received an average customer satisfaction rating of 4.6 stars on a 5-point scale. The net promoter score (based on consumers and families sharing the likelihood that they would refer others to SPARC services) was 4.3 stars.

Benefits Of Value-Based Reimbursement

Ms. Hermann explained that value-based treatment has incentivized service quality and built more staff buy-in for outcomes-driven treatment, afforded flexibility, and proved to be good for business development. She said, “We knew that the landscape of health care is shifting to value-based care, we want to jump in with both feet and have skin in the game. It forced us to say doing ‘A-level’ work isn’t good enough, we need to do ‘A-plus’ work. We committed to a pretty aggressive value-based contract because without that, we knew this would not be a sustainable model.”

The value-based model drives performance-based compensation incentives for staff, which increases their buy-in for achieving better outcomes. Ms. Hermann elaborated, “If a client is in crisis, the therapist response at eight o’clock at night is not just ‘Well go to the emergency room.’ Sometimes that’s a needed intervention but often it’s not. They know that once somebody goes to the emergency room, the whole treatment plan can get derailed. And so our clinicians want to go the extra mile, not only because it’s the right thing to do but also because we have some skin in the game. It creates just a little shift for them at the frontline level, so that they’re committed to providing unique services and really engage in creative problem solving.”

The services SPARC delivers under value-based contracts are labeled “in lieu of services” and have been designated by MCOs to meet an unmet need in their communities. Therefore service definitions afford more freedom and flexibility and avoid the need to fit the treatment model into a state plan amendment service definition which sometimes can be like “fitting a square peg in a round hole.” The VBR model is also designed to reduce administrative burden on provider organizations and payers. For example, given that FCT as an EBP is known to typically discharge families with successful outcomes after six months of treatment, six months of services are authorized at the outset. So instead of wrangling submissions for authorization, clinical professionals can focus on delivering needed services. And the intensity of treatment can be increased or decreased depending on current needs. “If a crisis happens and we need to increase the intensity and frequency of services, we don’t have to go back to that payer and request more time and risk potential denial. That is a huge difference between some of our fee-for-service vs. value based contracts,” said Ms. Herrmann.

Value-based contracting has created opportunity for SPARC to expand its mission to keep consumers out of institutional care. And it has allowed stakeholders to see their innovation and that creativity and to come to them when there are new needs. “It has allowed us to have opportunities that I’m not sure we would’ve had if we’d come in as a provider saying we want to do regular fee-for-service contracting,” Ms. Hermann said.

What’s next? As SPARC moves into providing more services for mild and moderate mental illnesses and pursues contracts with commercial insurance, value-based contracting will continue to define their business development efforts. They plan to work with their MCOs to move from an individual consumer focus to applying a population health lens in their VBR models. They are also looking to focus more on whole-person value-based care and to and certify and train staff to become a “care management agency” as part of North Carolina’s Medicaid transformation (see North Carolina Extends Deadline For Tailored Plan Care Management Applications To June 1, 2021). In addition to Cardinal Innovations Healthcare and Partners Behavioral Health Management, SPARC has entered into contracts with five more managed care organizations appointed by North Carolina Medicaid—WellCare of NC, AmeriHealth Caritas of NC, Blue Cross and Blue Shield of NC, United Healthcare of NC, and Carolina Complete Health, Inc. As these new MCOs get ready for value-based care—once they understand their new consumers and the needs—SPARC is well-poised to leverage their experience and hit the ground running. “We’re really committed to continuing to learn more and doing more in the value based space,” summarized Ms. Herrmann.

Don’t Leave Money On The Table: How The Right Technology Can Improve Your VBR Success

Value-based care is here! If you haven’t started thinking about what it is you need to compete in a value-based environment, now is the time to start. With the rise in value-based care contracts and utilization of alternative payment models, provider organizations are challenged with doing the research and homework to get prepared for these new ways of managing care.

Join us on Wednesday, May 26 at 1:00pm ET to hear an update on where we are with value-based care from OPEN MINDS Senior Associate, Ken Carr, as well as a firsthand case study from Capital Area Human Services (CAHS) on their journey to value-based care. CAHS Director of Business Development, Karla Lee Muzik, and Program Manager, John Nosacka, will showcase how their organization discovered they had been losing money by not having the right technology and how they began to remedy the problem.

During this session, attendees will:

  • Understand the current state of value-based care
  • Discover how to tell if they too are losing money with the wrong tools and technology
  • Hear a real-life case study from one provider organization who was losing money by not having the right tools to succeed with value-based contracting

Preparing For The Unknown: The Six EHR Functionalities Essential For Surviving During & After A Pandemic

White Paper Available Free Of Charge, Courtesy Of Qualifacts + Credible
& The Value Based Care For Behavioral Health Online Community

 

This last year has dramatically changed the world and with it, the health and human services industry. Large portions of staff are now working from home. Consumers are increasingly anxious and depressed from the days spent in quarantine, with some unable or unwilling to access behavioral health services. So, how is a provider organization to survive? What tools are needed to ensure survival in a global pandemic? How can we continue to safely service our most vulnerable populations?

To further understand what additional functionalities provider organizations needed to survive during and after the pandemic, OPEN MINDS and Qualifacts + Credible conducted the 2020 National Behavioral Health EHR Survey of provider organizations across the nation in the health and human services industry. The survey uncovered critical information on the purchasing and implementation behaviors of health and human service provider organizations related to EHRs and their functionalities.

This white paper has been provided to OPEN MINDS readers free of charge by The Value Based Care For Behavioral Health Online Community and Qualifacts + Credible.

About The Value Based Care For Behavioral Health Online Community

Your platform for building success with value-based care. Serving consumers with chronic conditions and complex support needs is a long and winding path. Let us be your guide, providing your team with the navigation tools needed for the transition to value-based reimbursement

Value Based Care for Behavioral Health is the only authoritative resource on value-based reimbursement developed for executives of health and human service organizations serving consumers with complex needs. Brought to you by OPEN MINDS and Qualifacts + Credible. Learn more or join at www.vbcforbh.com..

About Qualifacts + Credible

Qualifacts and Credible have merged. And we’re laser-focused on helping Behavioral Health and Human Services agencies improve clinical outcomes, enhance operations, and activate their full potential.

Please rest assured – the team and tech you love will remain in place. Providers will have the flexibility to choose and work with the two best-in-KLAS EHR solutions, CareLogic and Credible Behavioral Health. Our teams will continue to support both platforms and our agency partners from end to end.

Over time, we will fully bring to life the power and potential of this merger – to elevate agencies and create healthier communities – across our offering, team, and the industry. We’re excited for you to take this journey with us!

For more information, visit www.qualifacts.com..

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Why Measuring Performance & Tracking Outcomes Are Your Roadmap to Success: A Discussion With Eric Arnson, Chief Product Officer, Qualifacts + Credible

This presentation was delivered on March 10, 2021 at The OPEN MINDS Technology & Analytics Institute. In the presentation, the speakers highlighted the critical importance of your electronic health record’s (EHR) analytics and reporting functionality. The speakers discussed what is driving the trend towards greater need for outcomes tracking and reporting; how providers are using outcomes measures; and how the right EHR is vital in measuring performance measures and reporting outcomes to drive success. Additionally, the speakers provided a brief overview of the results of the 2020 National Behavioral Health EHR Survey results related to business intelligence, analytics, outcomes tracking, and reporting.

The presentation speakers included:

  • Eric Arnson, Chief Product Officer, Qualifacts + Credible
  • Joe Naughton-Travers, EdM, Senior Associate, OPEN MINDS

The Tech-Enabled Provider Organization: The 2020 OPEN MINDS Health & Human Service Technology Survey

As the health and human service market shifts to value-based reimbursement with a focus on cost and quality, specialty provider organizations will need to adopt new technologies to survive. Increasingly, there is a need for population health management, data exchange, and clinical decision support tools. For executives, linking technology investment to strategy is essential to success—performance, competitive advantage, and sustainability. OPEN MINDS surveyed specialty provider organizations in the health and human services to determine where they are on the road to technology adoption. The survey provides information on:

  • Technology adoption by market and organizational size
  • The number of full-time IT employees by market and organizational size
  • The size of IT budgets by market and organizational size
  • Trends in technology adoption by market and organizational size

A free copy of The Tech-Enabled Provider Organization: The 2020 OPEN MINDS Health & Human Service Technology Survey is available to all readers due to the generous sponsorship of Qualifacts + Credible.

Download Survey Results (PDF)

Preparing For The Unknown: A Sneak Peak At The 2020 National EHR Survey Results

The COVID-19 pandemic created substantial change across the health and human services industry. To understand the changes made and planned for EHR functionality during this changing time, we surveyed over 5,000 behavioral health provider organizations on their EHR purchasing and implementation behavioral and functionality status. Get a sneak peak of the 2020 National Behavioral Health EHR Survey results during this session courtesy of Qualifacts + Credible.

Download Presentation (PDF)