Behavioral Health

Behavioral Health

HMA annual conference on innovations in publicly sponsored healthcare

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Innovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth

Pre-Conference Workshop: October 29, 2023
Conference: October 30−31, 2023
Location: Fairmont Chicago, Millennium Park

Health Management Associates has announced the preliminary lineup of speakers for its sixth annual conference, Innovations in Publicly Sponsored Healthcare: How Medicaid, Medicare, and Marketplaces Are Driving Value, Equity, and Growth.

Hundreds of executives from health plans, providers, state and federal government, investment firms, and community-based organizations will convene to enjoy top-notch content, make new connections, and garner fresh ideas and best practices.

A pre-conference workshop, Behavioral Health at the Intersection of General Health and Human Services, will take place Sunday, October 29.

Confirmed speakers to date include (in alphabetical order):

  • Jacey Cooper, State Medicaid Director, Chief Deputy Director, California Department of Health Care Services
  • Kelly Cunningham, Administrator, Division of Medical Programs, Illinois Department of Healthcare and Family Services
  • Karen Dale, Chief Diversity, Equity, and Inclusion Officer, AmeriHealth Caritas
  • Mitchell Evans, Market Vice-President, Policy & Strategy, Medicaid & Dual Eligibles, Humana
  • Peter Lee, Health Care Policy Catalyst and former Executive Director, Covered California
  • John Lovelace, President, Government Programs, Individual Advantage, UPMC Health Plan
  • Julie Morita, MD, Executive Vice President, Robert Wood Johnson Foundation
  • Anne Rote, President, Medicaid, Health Care Service Corp.
  • Drew Snyder, Executive Director, Mississippi Division of Medicaid
  • Tim Spilker, CEO, UnitedHealthcare Community & State
  • Stacie Weeks, Administrator/Medicaid Director, Division of Health Care Financing and Policy, Nevada Department of Health and Human Services
  • Lisa Wright, President and CEO, Community Health Choice

Publicly sponsored programs like Medicare, Medicaid, and the Marketplaces are leading the charge in driving value, equity, and growth in the U.S. healthcare system. This year’s event will highlight the innovations, initiatives, emerging models, and growth strategies designed to drive improved patient outcomes, increased affordability, and expanded access.

Conference Agenda

Early bird registration ends July 31. Questions may be directed to Carl Mercurio at cmercurio@healthmanagement.com. Group rates, government discounts, and sponsorships are available.

Register Now

Child and family wellbeing: May is National Foster Care Month

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This is part of an ongoing series highlighting efforts in Human Services and Family Wellbeing. 

During the month of May, National Foster Care Month provides an opportunity to raise awareness on issues related to foster care and to celebrate those who are dedicated to serving our children, youth, and families. Yet it is important to note that unfortunately issues surrounding children and youth experiencing foster care are not limited to one month a year. As noted in our recent child well-being blog, Child welfare services face challenges every day to prevent, treat, and reduce risk of maltreatment, neglect, trauma, housing instability, and violence in communities. All these issues contribute to the significant number of children and youth who enter or remain in the foster care system. These issues are year-round and decades in the making. They need to be seen as a priority for public health and community wellbeing and not just the jurisdiction and responsibility of child welfare agencies.

To positively impact the number of children and youth experiencing foster care, there are some strategies that can be implemented now to promote change:

  • We must meaningfully elevate the voices of those with lived experience to help us design systems that meet their needs. For foster care, working to hear and understand the voices of youth based on how they have experienced foster care will help create opportunities to improve the system from those most impacted. Further, the meaningful elevation of these voices helps to ensure their input is not contributing towards tokenism and re-traumatization.
  • Multi-system involvement is important. We can work together to enhance access, increase prevention-oriented services, improve community health, and well-being, and achieve better outcomes using an equity lens, but proposed system reforms cannot be successful without shared ownership within the community and across government agencies. This requires building a responsive and integrated system of care approach to allow communities to seek solutions with the necessary support of the highest leadership within their organizations.   
  • Continue to find ways to assure that mandated reporters and staff who work within child welfare understand that poverty is not neglect, and poverty alone should not be a reason children and youth are removed from their home(s).
  • System redesign is needed. From front end reporting and assessment, to working with court systems, to building up networks of caring service providers, each component of the current child welfare system and human services partners can strive to find areas needing improvement and collectively change the experiences for children and youth engaged in the child welfare system.
  • Focus on mental health. This year’s theme from the Children’s Bureau for national foster care month is “Strengthening Minds, Uplifting Families” and is dedicated to supporting children and youth mental and behavioral health as the largest unmet need related to foster care. According to the Children’s Bureau, Up to 80 percent of children experiencing foster care have significant mental health issues, compared with approximately 18 to 22 percent of the general population.[1]

HMA can help public sector and community partners align themselves to improve and develop new delivery systems that will work to address inequalities and disparities as communities strive to meet the needs of children, youth and families impacted by issues like mental health and substance use disorder, domestic violence, child abuse and neglect, food insecurity, housing instability, incarceration and other traumas that impact them greatly.

HMA can help support foster care prevention or reunification program efforts in the following ways:

  • Creating additional human service system integration of prevention services to help support families and youth experiencing child welfare interventions or foster care.
  • Increasing Medicaid providers who offer more Evidenced Based and Informed Practices (EBP) among Community Based Organizations (CBO), Providers, and Local Government. 
  • Supporting Managed Care Organizations to develop programs specifically designed to support the wellbeing of children and youth in the foster care system and their families.
  • Connecting the Family First Prevention Services Act (FFPSA) & Medicaid funding together to ensure that funding supports the need and enhance service implementation.
  • Working to implement School Based Mental Health programs in communities.  We can help convene stakeholders, create process flows, and support the development of sustainable funding for such programs.
  • Increasing the meaningful use of youth voice for true collaboration in system redesign.
  • Enhancing judicial engagement with the child welfare system in a way that supports meaningful youth and family voice and representation in court while maintaining the child welfare system’s responsibilities around assuring child safety.  Making the court process less traumatic for children and youth and more part of a solution for them will support better outcomes.
  • Recognizing longstanding racial inequities in foster care experiences that can and should be addressed holistically in communities and supporting efforts to understand the root causes for the disparities in foster care placement.

Read other parts of this blog series:

If you have questions on how HMA can support your efforts in Child and Family Wellbeing, please contact: Uma Ahluwalia, MSW, MHA, Managing Principal, John Eller, Principal, Jon Rubin, Principal, or Nicole Lehman, Senior Consultant.

[1] Data:  https://www.childwelfare.gov/fostercaremonth/awareness/facts/

Child and family wellbeing: family resilience

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This is part of an ongoing series highlighting efforts in human services and family wellbeing. 

For decades, practitioners have recognized that child neglect was often interconnected in some families with stressors associated with familial poverty. Poverty is often a stressor in cases of child neglect, poor health, and even youth incarceration. Food insecurity, housing instability, and family stressors often related to unemployment, incarceration, and domestic violence can in some circumstances, result in parental burnout and lead to poor parenting decisions. There is also a perverse disincentive for families to experience career and wage progression which often results in steep fiscal cliffs with benefits that are needed to stabilize families and guide them towards economic self-sufficiency[1]. There is advocacy and increasing recognition through efforts such as Universal Basic Income Pilot programs and experiments with expanding Earned Income Tax Credits and Child Tax Credits attempting to mitigate catastrophic benefits cliffs that impact child and family wellbeing and economic self-sufficiency.

Public Safety Net programs such as Temporary Assistance to Needy Families, Supplemental Nutrition Assistance Program, WIC, Free and Reduced School Meals, Child Care Subsidies, Earned Income Tax Credit, Eviction Prevention Grants, and a host of other federal, state, and local programs are intended to support and strengthen families and increase protective factors for children[2].   

Recent investments in the safety net including the childcare tax credit and the Pandemic Electronic Benefit Card (P-EBT) have shown that when concrete supports are provided to families, child maltreatment rates significantly decrease.[3]  

During the height of the COVID-19 pandemic, the federal government implemented a One-Year Expansion of the Child Tax Credit which extended the eligibility to families with little to no income. It helped increase the credit amount families received from $3,600 per qualifying child younger than six years old and $3,000 for qualifying child between the ages of 6 and 17. It also provided monthly payments of $250 to $300 per qualifying child as opposed to an annual payment which aligned with monthly living expenses. According to the US Census Bureau, 2021 saw a historic decline in child poverty which lifted one million children under the age of six out of poverty, and 1.9 million for children between the ages of six and 17.  

More recently States are experimenting with Universal Basic Income projects aimed at reducing child poverty, improving protective factors in families and reducing child maltreatment.[4] These experiments are currently being evaluated, but early research is showing promising signs of reduced child poverty in jurisdictions where these projects have gone live. 

There is considerable literature that shows that changes in income alone, holding all other factors constant, have a major impact on the numbers of children being maltreated. Conversely, reduction in income or other economic shocks to the family increase incidents of child maltreatment. 

A study performed by the Nuffield Foundation noted that internationally, evidence has shown a much stronger relationship between poverty and child abuse and neglect. Research has shown that without government and service providers responding to increased pressures on family life will lead to the risk of more children suffering harm, abuse and neglect.[5]

 Another study by Casey Family Programs on predicting chronic neglect, found that the strongest predictors of chronic neglect were parent cognitive impairment, history of substitute care, parent mental health problems, and a higher number of substantiated allegations in the first CPS report[6]. This suggests that families at risk for chronic neglect face multiple challenges and significant financial insecurity that require significant support.

  • Other significant predictors include:
    • Younger parents
    • Families with a higher number of children
    • Families with a child under age 1

Recognizing these challenges to strengthening the protective factors for young moms, there have been several successful efforts around the country to focus on pregnant and parenting teen and young adult moms. From Health Families America, Nurse Home Visiting Programs, there has been a body of evidence created that shows the strengths of providing wrap around services and home-based interventions for moms and babies. These supports strengthen the mom-baby nurturing relationship and reduce risk of maltreatment and increase protective factors. 

One such organization that has demonstrated significant success in disrupting the cycle of generational poverty is The Jeremiah Program. This is a national organization that aids single mothers and their children to provide coaching and assistance in navigating barriers to education, college access and career support, safe and affordable housing, early childhood education and childcare, and empowerment, leadership, and career training. This supportive program helps build up single mothers to achieve their educational and career goals and gain long-term economic prosperity. 

As child welfare and poverty policies intersect, the current thought leadership is focused on recognizing that economic and concrete supports reduce involvement in child welfare.[7] As the science and voices of children and families with lived experience intersect and rise up, the federal and state policy landscape around alleviating poverty to improve child wellbeing will continue to gain momentum. Family and Child Well-Being indicators significantly reflect racial and ethnic inequalities both in child welfare and across the poverty landscape. Economic stability is also a key strategy to address racial and ethnic inequalities and closing the opportunity gap for all. Over the next 3-5 years we believe there will be a fundamental shift in policy, financing, and outcomes tracking that reflect our commitment to our society’s most vulnerable children and families. That is why it is crucial for States and Local governments to enact policies that would support programming to alleviate poverty and improve child and family resilience and protective factors.

HMA consultants have decades of experience working hand-in-hand with public health, social services, behavioral health, Medicaid, and human services agencies. We help strengthen relationships surrounding policy, practice and revenue maximization in the human services space. Our experts work to help support programs in areas of Nutrition: Women, Infants & Children (WIC), Supplemental Nutrition Assistance Program (SNAP); Financial Support: Child Support, Temporary Assistance for Needy Families (TANF); Child and Adult Welfare Services; Medicaid; Housing and Weatherization; Early Education: Childcare Subsidy, Child Care and Development Block Grant (CCBDG) programs; and Workforce Development and Workforce Innovation and Opportunity Act (WIOA) programs.

If you have questions on how HMA can support your efforts in Child and Family Wellbeing, please contact Uma Ahluwalia, MSW, MHA, Managing Principal or Kathryn Ngo, MPH, BSN, Project Manager.

[1] What Are Benefits Cliffs? – Federal Reserve Bank of Atlanta (atlantafed.org)

[2] Economic Supports Chapin Anderson Nov 2020b (chapinhall.org)

[3] Research Reinforces: Providing Cash to Families in Poverty Reduces Risk of Family Involvement in Child Welfare | Center on Budget and Policy Priorities (cbpp.org)

[4] Understanding The Difference Between Guaranteed Basic Income Vs Universal Basic Income – Orange and Blue Press

[5] https://www.nuffieldfoundation.org/news/relationship-between-poverty-and-child-abuse-and-neglect

[6] Predicting Chronic Neglect – Casey Family Programs

[7] Economic Supports Chapin Anderson Nov 2020b (chapinhall.org)

Value-Based Payment (VBP) – Is your organization ready?

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Utilization of value-based payment (VBP) strategies continues to expand, with states and health plans recognizing the benefits of rewarding outcomes over volume. This includes population based VBP initiatives intended to address disparities. Health Management Associates (HMA) is at the center of these initiatives, supporting payers with development and implementation, as well as supporting providers through the transition from a traditional FFS model to maximizing reimbursement through effective care delivery, supported by the necessary administrative infrastructure and resources. As our clients in health care communities move forward with alternative payment models, we have developed tools and strategies to achieve the essential milestones to successful implementation.

Milestone 1: Provider Readiness Assessment

Successful planning for the transition to VBP begins with an understanding of where your organization is starting from, informing the targeted milestones associated with each providers’ unique strengths and challenges.

Understanding that success under VBP models requires adjustment of both clinical and administrative practices, HMA has created an assessment tool that considers the programmatic, financial, and technology resources necessary for VBP implementation. In addition to the ability to leverage these resources, organizations must have the capacity for VBP components such as cost reporting, revenue cycle management, and real time risk monitoring through the collection and analysis of data.  

“With VBP on the horizon for our organization, HMA helped us to determine our readiness and to devise a strategy to remediate gaps in operations in order to be successful with the new payment model.”

– Tamara Player, CEO; Polara Health, AZ

Milestone 2: Strategy Development and Change Management

A change in reimbursement methodology requires organizational realignment of administrative and programmatic approaches. Assessing and supporting staff through these changes is a key milestone for success. Activities in which HMA have supported our clients include:

Creating leadership and governance buy-in

Preparing the Board and Staff for VBP

Aligning mission and vision with payment models and accountability metrics

Project Management, including development and monitoring of implementation plans

Cross functional team support

Milestone 3: Data Collection and Reporting Capabilities

The ability to collect and report meaningful outcomes is at the core of successful engagement in VBP. Following an assessment of current capabilities, HMA has supported provider organizations in maximizing electronic health record and other data system capabilities to capture data essential for reimbursement, as well as increasing analytic capabilities that are essential for monitoring outcomes to ensure programs can pivot when data indicates outcome achievement may be at risk. Activities include:

Technology and Data Enterprise configuration to support analytics and reporting

Creating real-time access to data

Benchmarking current outcomes against proposed VBP metrics

Alignment of current framework to payer metrics

Creation of internal clinical leadership infrastructure to support proactive monitoring and action in response to data

Milestone 4: Business Office and Finance

All aspects of an organization’s financing can be impacted by transitions in payment methodology, including cash flow, impacting cash on hand for capital and other expenses. Anticipating these changes and adjusting accordingly are key to readiness for VBP and importantly, mitigating risk during the transition. HMA can assist with:

Assessing organizational ability to accept risk

Developing a risk corridor based on organizational readiness

Negotiating alternative payment arrangements with payers

Milestone 5: Clinical Programmatic Approaches under VBP

VBP arrangements provide opportunities for organizations to move closer to the goal of achieving outcomes for their clients, rather than productivity targets and units of service. This includes incorporating approaches that could not receive reimbursement under an FFS model. With this flexibility comes the opportunity to review and adapt clinical approaches and programming, including population specific strategies. HMA is ready to support these efforts through:

Workforce analysis

Re/design of clinical workflows  

Implementation of measurement-based care

Optimization of clinical templates within the EHR to support data collection and reporting

Understanding the opportunities of value-based payment across the continuum of payment models

While these activities may seem overwhelming, HMA is ready to support your organization to receive reimbursement based on meaningful improvement for your clients through technical assistance and training on each of the core elements outlined above.

Contact our experts:

Rachel Bembas

Principal

Rachel Bembas is a results-driven leader in behavioral health quality and population health analytics who has worked extensively to advance … Read more

Roxanne Kennedy

Principal

Dr. Roxanne Kennedy is a licensed clinical social worker (LCSW) with more than thirty years of experience providing clinical and … Read more

Debbi Witham

Principal

Debbi Witham is a seasoned executive with experience delivering high quality, mission driven healthcare. During her career, she has focused … Read more

Biden administration encourages states to apply for Medicaid Reentry 1115 Demonstration for individuals in carceral settings

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This week our In Focus section reviews guidance from the Centers for Medicare & Medicaid Services (CMS), released on April 17, 2023, encouraging states to apply for the new Medicaid Reentry Section 1115 Demonstration Opportunity. The demonstration is aimed at helping improve care for individuals in carceral settings prior to their release.

Background

The United States has approximately 1.9 million individuals incarcerated nationwide. Studies have shown higher rates of mental illness and physical health care needs in incarcerated populations compared to the general population, as well as associations between jail incarceration and increases in premature death rates from infectious diseases, chronic lower respiratory disease, drug use, and suicide.

CMS states that formerly incarcerated individuals with physical and mental health conditions and substance-use disorders (SUDs) typically have difficulty succeeding upon reentry due to obstacles present immediately at release, such as high rates of poverty and high risk of poor health outcomes. These individuals tend to face barriers in obtaining housing, education, employment, and health care access upon release. They often do not seek outpatient medical care and are at significantly increased risk for emergency department (ED) use and hospitalization.

Purpose and Goals

After collecting feedback from stakeholders, including managed care organizations, Medicaid beneficiaries, health care providers, the National Association of Medicaid Directors, and other representatives from local, state, and federal jail and prison systems, CMS designed the Reentry Section 1115 Demonstration Opportunity. The services covered under this demonstration opportunity should aim to improve access to community resources that address the health care and health-related social needs of the carceral population, with the aims of improving health outcomes, reducing emergency department visits, and inpatient hospital admissions for both physical and behavioral health issues once they are released and return to the community.

The purpose of this demonstration opportunity is to provide short-term Medicaid enrollment assistance and pre-release coverage for certain services to facilitate successful care transitions. The full goals, as quoted from CMS, are as follows:

  • “Increase coverage, continuity of coverage, and appropriate service uptake through assessment of eligibility and availability of coverage for benefits in carceral settings just prior to release
  • Improve access to services prior to release and improve transitions and continuity of care into the community upon release and during reentry
  • Improve coordination and communication between correctional systems, Medicaid systems, managed care plans, and community-based providers
  • Increase additional investments in health care and related services, aimed at improving the quality of care for beneficiaries in carceral settings and in the community to maximize successful reentry post-release
  • Improve connections between carceral settings and community services upon release to address physical health, behavioral health, and health-related social needs
  • Reduce all-cause deaths in the near-term post-release
  • Reduce number of ED visits and inpatient hospitalizations among recently incarcerated Medicaid beneficiaries through increased receipt of preventive and routine physical and behavioral health care”

CMS encourages states to engage with individuals who were formerly incarcerated when contemplating the design and implementation of their proposal. CMS also encourages states to design a broadly defined demonstration population that includes otherwise eligible, soon-to-be former incarcerated individuals. States have the flexibility to target population, such as individuals with specific conditions, but are encouraged to be mindful of undiagnosed conditions. States should have a plan to ensure incarcerated individuals will be enrolled in Medicaid upon their release, applying for Medicaid no later than 45 days before the day of release.

Reentry Section 1115 Demonstration Opportunity

To receive approval for the demonstration, the state proposal must include in the pre-release benefit backage:

  1. Case management to assess and address physical and behavioral health needs and health-related social needs;
  2. Medication-assisted treatment (MAT) services for all types of SUD as clinically appropriate, with accompanying counseling; and
  3. A 30-day supply of all prescription medications that have been prescribed for the beneficiary at the time of release, provided to the beneficiary immediately upon release from the correctional facility.

In addition to these three services states may include other important physical and behavioral health services to cover on a pre-release basis, such as family planning services and supplies, behavioral health or preventive services, including those provided by peer supporters/community health workers, or treatment for Hepatitis C. CMS is also open to states requesting Section 1115 expenditure authority to provide medical supplies, equipment, and appliances.

The Reentry Section 1115 Demonstration opportunity is not intended to shift current carceral health care costs to the Medicaid program. CMS will not approve state proposals to receive federal Medicaid matching funds for any existing carceral health care services funded with state or local dollars unless the state agrees to reinvest the total amount of new federal matching funds received into activities or initiatives that increase access to or improve the quality of health care services for individuals who are incarcerated.

CMS also expects states to refrain from including federal prisons as a setting in which demonstration-covered prerelease services are provided under the opportunity.

States with approved demonstrations will need to submit an implementation plan, a monitoring protocol, quarterly/annual monitoring reports, a mid-point assessment report, an evaluation design, and interim/summative evaluation reports.

California

California became the first state to receive approval for a Section 1115 waiver amendment earlier this year to provide limited Medicaid services to incarcerated individuals for up to 90 days immediately prior to release. The approval period runs through December 31, 2026, timed with the expiration of the CalAIM Medi-Cal waiver demonstration. California’s reentry demonstration initiative aims to provide health care interventions at earlier opportunities for incarcerated individuals to reduce acute services utilization and adverse health outcomes. The state anticipates it will increase coverage and continuity of coverage for eligible beneficiaries, improve care transitions for beneficiaries as they reenter the community, and reduce morbidity and mortality in the near-term post-release.

Pre-release services include comprehensive care management, physical and behavioral clinical consultation, lab and radiology, MAT, community health worker services, and medications and durable medical equipment. A care manager will be assigned to eligible individuals to establish a relationship, understand their health needs, coordinate vital services, and make a plan for community transition, including connecting the individual to a community-based care manager they can work with upon their release. Additionally, all counties implementing Medi-Cal application processes in jails and youth correctional facilities will “suspend” the Medicaid status while an individual is in jail or prison, so that it can be easily “turned on” when they enter the community.

On April 6, 2023, HMA held a webinar titled, “Medicaid authority and opportunity to build new programs for justice-involved individuals.” A replay can be watched here. HMA will announce additional webinars on the topic.

Link to Press Release and Letter

Child and family wellbeing

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Child welfare services face challenges every day to prevent, treat, and reduce risk of maltreatment, neglect, trauma, housing instability, and violence in communities. These issues need to be seen as a priority for public health and community wellbeing and not just the jurisdiction and responsibility of child welfare agencies.

There are many opportunities for improvement in this area, including:

Integrating prevention services within the human services system to help support families and youth experiencing child welfare interventions

Providing technical assistance and supports to systems serving child welfare and justice-involved youth, including: policy and practice reviews, workforce and workload analyses, process re-engineering

Increasing Medicaid providers who offer more community based Evidenced Based and Informed Practices (EBP) among Community Based Organizations (CBO), Providers, and Local Government entities

Developing the workforce to enable prevention programs and building competencies to engage in meaningful interactions with children, youth, and families

Addressing disparities in both experiences and outcomes for children, youth and families, rather than focusing on responding through merely a transactional and compliance driven approach

If your organization works to help meet the needs of children, youth and families impacted by issues like mental health and substance abuse, domestic violence, child abuse and neglect, food insecurity, housing instability, incarceration, and other traumas, Health Management Associates (HMA) can help make your efforts more effective.

Together we can help you move programs upstream with strong prevention and family strengthening approaches and integrate payment models with the human services delivery system to streamline and improve resources. 

HMA can help in the following ways:

Developing system integration models

Strategies to improve school-based mental health support implementation

Provide technical assistance and consulting support regarding service access and expansion of Medicaid utilization for implementation of evidence-informed programs

Workforce planning and strategy

Assist states, counties, hospitals, providers, and MCO’s address the challenges of hospital overstays and behavioral health placements

Provide technical assistance to state and local governments regarding limiting exposure to class action lawsuits or providing expert witness services

Strategic planning

Program evaluation, research and analysis including cost/benefit analysis of programs

Leadership development

Stakeholder engagement

A longtime leader in health and human services, HMA experts have front line and executive level experience providing direction to child welfare programs.

We consult with public and private sector entities who serve children and families to improve, streamline and integrate essential services. We ground our work in human-centered design, lived expertise, and change management and leadership principles in state and county program development.

Contact our experts:

Ahluwalia_Uma_DC headshot

Uma Ahluwalia

Managing Principal

Uma S. Ahluwalia is a respected healthcare and human services professional with extensive experience leading key growth initiatives in demanding … Read more

John Eller

Principal

John Eller is a seasoned executive with more than 23 years of service in public administration and health and human … Read more

Jon Rubin

Principal

Jon Rubin is a human services leader with over 20 years of experience in strategic planning, identifying and analyzing problems, … Read more
Doris Tolliver

Doris Tolliver

Principal

Doris Tolliver is a strategic thinker specializing in racial and ethnic equity, organizational effectiveness, change management, and business strategy development. She … Read more

HMA’s CCBHC program implementation support

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Implementation

Since the inception of the Certified Community Behavioral Health Clinics (CCBHC) model, we’ve been working across the country with designated CCBHCs, to help implement the model in ways that maximize the value of the designation.

We’ve worked with a diverse range of behavioral health providers and other stakeholders in planning for and implementing the CCBHC model both within the demonstration program framework, as well as through federally funded CCBHC-expansion grants. Our team of experts supports providers to leverage the CCBHC model to support their overall agency mission and growth goals. 

APPROACH

HMA’s CCBHC-related support spans a spectrum from strategic planning through grant securing, grant implementation, organizational change management, to demonstration program participation. HMA offers implementation support that is customized to each organization and its unique circumstances, while leveraging our unmatched breadth of experience with Substance Abuse and Mental Health Services Administration (SAMHSA), CCBHCs, behavioral health treatment and support services, state Medicaid systems, clinical integration, health information technology, quality improvement, healthcare finance, and strategy.

Strategic planning to see how CCBHCs can support each agency to meet its goals

Readiness assessment to best position the agency for CCBHC certification in a competitive landscape

Write SAMHSA proposals to secure CCBHC grant funding

Implementation support in alignment with CCBHC criteria, as well as SAMHSA and state requirements

Ongoing quality improvement to support improvement and advancement of CCBHC programming

Help agencies transition from CCBHC grant funding to a sustainable reimbursement model

In addition, HMA can support a CCBHC implementation with any or all of the following services: financing, workforce recruitment/retention strategies, project management, technical assistance, and health information technology and exchange.

RESULTS

In 2022 alone, we supported behavioral health providers to attain more than $110 million in expansion grant funding they will use in their communities, including over $46 million in CCBHC-planning, development, and implementation grant funding and more than $63 million in CCBHC-improvement and advancement grant funding.

In addition, we have supported more than 20 states to write their CCBHC planning grant applications to initiate a state-run CCBHC model. Most recently, we had 100% success rate for our FY23 planning grant applications, resulting in four states receiving one year planning grants to build a state-run CCBHC model.

Contact our experts:

Kristan McIntosh headshot

Kristan McIntosh

Principal

Kristan McIntosh specializes in behavioral health programming designed to both enhance access to community-based care and facilitate program and organizational … Read more

Josh Rubin

Principal

Josh Rubin provides consultation, strategic planning, analysis, and technical assistance to health care purchasers, providers, platforms, and regulators with a … Read more

Integrating behavioral health & general medical care is vital to reach the triple aim

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The integration of behavioral health and medical care has emerged as a crucial method for improving health and reducing the cost of care. Integrated care offers solutions and advancements in healthcare delivery by improving access to behavioral healthcare, including scarce psychiatric resources, reducing stigma, and enhancing behavior change in everyday life.

As an emerging standard of care, policy makers, payers, and leaders are expecting organizations to develop evidence based approaches to team based care that can demonstrate health outcomes and cost savings. HMA can help your organization navigate this important culture change. Our multidisciplinary team includes clinical, finance and payment, and policy experts with hands-on experience in integrated care service delivery.

Our integration experts can help your team with:

Readiness assessment

Evidence based policy, finance, and model design

Technical assistance, training, team based care

Operational changes including billing, HIE, credentialing

Measurement based care metrics and evaluation

Cultural change and leadership

We are working with an array of clients on integration

Health plan integration

State departments & statewide implementation

Integrated delivery systems

Hospital based providers

PCMH & FQHC primary care providers

Accountable care organizations

Certified community behavioral health clinics and other BH providers

Department of corrections

Contact our experts:

Marc Avery headshot

Marc Avery

Principal

Marc Avery, MD, is a board-certified psychiatrist and a recognized leader in person-centered, integrated psychiatric care for high needs and … Read more

Jennifer Hodgson

Principal

Jennifer Hodgson is a licensed marriage and family therapist who maintained a private practice and taught in higher education for … Read more
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Gina Lasky

Co-Managing Director, Behavioral Health

Gina Lasky is a licensed psychologist with expertise in public sector behavioral health system design and programming including integration of … Read more

Implementation Accelerator: leadership training through application 

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The healthcare industry is constantly evolving and requires a workforce that is responsive and able to lead and adapt to changes. Healthcare professionals are continually asked to incorporate new services, care models, quality measures, and process improvements into daily work. 

While clinical innovations and operational improvements are promising, there is growing recognition of the gap between plans to implement them and actual implementation. 

HMA has extensive leadership, operational, and clinical expertise working directly with health systems, health plans, providers, foundations, community-based organizations, and associations adopt implementation science informed approaches for successful change. 

Drawing on this experience, we developed the HMA Implementation Accelerator, a leadership development framework that utilizes implementation science to address on-the-ground challenges and lead successful implementation efforts. 

“The importance of leadership is noted in just about every discussion of implementation. The absence of leadership support is a well-documented barrier, and success is attributed to the presence of leadership support.”

– Active Implementation Research Network

HMA Implementation Accelerator

PEOPLE

Leadership development

Build knowledge, skills, and abilities and apply them to implementation

Change agent engagement and development

Identify formal and informal leaders to inform, support and influence engagement

Implementation approach training

Build knowledge and skills critical to successful implementation

PROCESS

Project management

Develop or enhance structures and approach to guide implementation

Continuous improvement and critical feedback

Integrate structures and practices that facilitate continuous improvement, sustain momentum, and highlight critical adaptation

Communication planning

Plan and deploy intentional, pro-active communication strategies to effectively guide and support implementation

Tool development

Identify, develop, and deploy tools that support effective implementation and create efficiencies for implementation teams

Sustainability planning

Pro-actively plan for sustainability from outset

PURPOSE

Executive sponsorship

Engage and activate sponsorships for critical support and resources

Align implementation with mission

Connect implementation efforts to a larger “why” in alignment with mission

What’s included

Conceptual framework to guide implementation process

Strategies to develop effective sponsorship at the executive or senior leadership level to mitigate barriers and resource effort

Leadership skill development at the level of implementation

Processes to enhance effective ownership and commitment at all levels

Prioritization of change initiatives

Clear accountability of actions in implementation

Continuous quality improvement as part of implementation

Sustainability planning from the start

Research shows that successful leadership development occurs when the learning can be directly applied to active work processes, which aligns with how adults learn most effectively.

Through the Implementation Accelerator, we use a combination of interactive training, peer learning, and coaching to support hands-on learning. The integration of leadership development and implementation science provides a robust opportunity to develop and sustain leadership skills and develop an organizational methodology to guide both current and future implementation efforts.

Contact our experts:

Suzanne Daub headshot

Suzanne Daub

Principal

Suzanne Daub is a leading expert and nationally recognized trainer in integrated healthcare who knows how to help clients design, … Read more
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Marsha Johnson

Managing Principal

Marsha Johnson is a leader in complex care program development, integrated health delivery, curriculum development, and workforce and leadership development. … Read more
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Elizabeth Wolff

Principal

Elizabeth Wolff, MD, MPA is a physician executive who utilizes her expertise in population health, quality improvement, and practice operations to … Read more

Demonstrating quality, value, and equity in behavioral health

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HMA’s team of over 50 behavioral health experts have direct experience in behavioral health policy, clinical program design and delivery, quality improvement and financing. Our breadth of expertise, including authors of NCQA’s Behavioral Health Quality Framework to Promote Joint Accountability, positions us well to support the design, delivery and payment of high quality behavioral health care.

We help clients demonstrate the value of their behavioral health care through:

Accreditation Readiness

Meet accreditation standards and demonstrate compliance

Analyze and use behavioral health-specific HEDIS, CAHPS/ECHO, HOS, ASAM/CARF to inform QI

Use key data sources to drive performance improvement plans

Use of Behavioral Health Quality Tools

Behavioral health network adequacy and equitable access

Integration of behavioral health, physical health and social needs

Measurement-based care

Patient outcomes

Cohesive Strategy Development

Behavioral health quality strategy planning aligned with organizational mission and vision

Standardized performance metrics

Value-based care and payment incentives

Pragmatic regulatory tools and policies

HMA is positioned to support

State and municipal departments of health and public health

Health plans & Managed Care Organizations

Health systems

Provider organizations

Community-based organizations

Certified community behavioral health clinics

Correctional health

Accreditation Readiness

Meet accreditation standards and demonstrate compliance

Analyze and use behavioral health-specific HEDIS, CAHPS/ECHO, HOS, ASAM/CARF to inform QI

Use key data sources to drive performance improvement plans

Use of Behavioral Health Quality Tools

Behavioral health network adequacy and equitable access

Integration of behavioral health, physical health and social needs

Measurement-based care

Patient outcomes

Cohesive Behavioral Health Quality Strategy Development

Behavioral health quality strategy planning aligned with organizational mission and vision

Standardized performance metrics

Value-based care and payment incentives

Pragmatic regulatory tools and policies

HMA is positioned to support

State and municipal departments of health and public health

Health plans & Managed Care Organizations

Health systems

Provider organizations

Community-based organizations

Certified community behavioral health clinics

Correctional health

Contact our experts:

Rachel Bembas

Principal

Rachel Bembas is a results-driven leader in behavioral health quality and population health analytics who has worked extensively to advance … Read more

Lauren Niles

Principal

Lauren Niles, DrPH, MPH is an experienced and passionate healthcare quality subject matter expert and researcher. She has experience with … Read more

Serene Olin

Principal

Su-chin Serene Olin, PhD, is a child clinical psychologist with over 20 years of translational research and leadership experience integrating … Read more

Debbi Witham

Principal

Debbi Witham is a seasoned executive with experience delivering high quality, mission driven healthcare. During her career, she has focused … Read more