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Medicaid Managed Care – What Is It; How to Prepare

If you provide behavioral or physical health services for Medicaid consumers, you have probably heard about the changes to both systems. You may have even heard that you need to prepare for Medicaid Managed Care. What is managed care?

Managed Care is a term that is used to describe a health insurance plan or health care system that coordinates the provision, quality and cost of care for its enrolled members. – NY State Department of Health

What isn’t discussed is how to prepare your organization and staff for this change. What steps need to be taken? Do you have the infrastructure and right people in place to take those steps? How do you measure your achievements and outcomes? Are those the achievements and outcomes Medicaid Managed Care will find valuable?  CCNY, Inc. is here to help with an infographic describing the steps, and expectations to prepare your organization for Managed Care.

ccny_managedCare

[PDF Version]

CCNY works with health and human service organizations to provide data-driven recommendations that will improve the organization. If you are interested in getting support in this process, contact us for more information.  We would be happy to help.

 

 

To Prepare for Managed Care, You Will Need to Combine Data on Fiscal and Clinical Performance

Jamie Stewart of Open Minds, a market and management best-practice firm supporting health and human service organizations, wrote an excellent article on the challenges for the Behavioral Health system, “Are You Ready To Be A Certified Community Behavioral Health Center?” He says,

The CFO’s biggest challenge now is finding a way to combine fiscal data systems with clinical performance management to produce the management data needed to hit payer-mandated performance requirements and manage value-based contracts.

In order to gather, analyze, and display this data, you may need to integrate data sets that are not connected to each other. For example, you accounting and fiscal management software may not be integrated with your Electronic Health Record in a way that helps you understand the cost of services. You will need not only know how well your clients are performing on clinical outcomes, but also how much those outcomes cost your agency to provide. 

Open Minds have several articles on this issue that may help:

If you need assistance in gathering, integrating, and developing dashboards to support this work, let us know. We would love to speak to you.

Steps for Preparing for Managed Care [Infographic]

If you provide behavioral or physical health services for Medicaid consumers, you have probably heard about the changes to both systems. You may have even heard that you need to prepare for Medicaid Managed Care. What is managed care?

Managed Care is a term that is used to describe a health insurance plan or health care system that coordinates the provision, quality and cost of care for its enrolled members. – NY State Department of Health

What isn’t discussed is how to prepare your organization and staff for this change. What steps need to be taken? Do you have the infrastructure and right people in place to take those steps? How do you measure your achievements and outcomes? Are those the achievements and outcomes Medicaid Managed Care will find valuable?  CCNY, Inc. is here to help with an infographic describing the steps, and expectations to prepare your organization for Managed Care.

ccny_managedCare

[PDF Version]

If you are interested in getting support in this process, contact us for more information.  We would be happy to help.