OASAS Vision of Treatment System Change & How to Support It CASA-MCTAC OASAS Vision of Treatment System Change & How to Support It 12 October 2015

CASA-MCTAC CASAColumbia Healthcare Reform: (‘The National Center on Addiction and Substance Abuse at Columbia University’) Healthcare Reform: Opportunities and Reasons for Optimism MCTAC (Managed Care Technical Assistance Center)

CASAColumbia Science-based, multidisciplinary organization Focused on transforming society’s understanding of and responses to substance use and the disease of addiction Translating and disseminating research findings to: link ‘science to policy to practice’ bridge gaps that block progress by removing stigma and improving outcome improve prevention and treatment practices

CASAColumbia Reports Well-documented track record of increasing the impact of scientific findings by getting them into the hands of: medical and public health experts state and local health commissioners national public policy makers Select examples of pioneering reports widely distributed and cited over the past 20 years include: Cost of Substance Abuse to America’s Health Care System: Medicare and Medicaid Addiction Medicine: Closing the Gap Between Science and Practice Adolescent Substance Use: America’s #1 Public Health Problem Shoveling Up: The Impact of Substance Use on Federal, State, and Local Budgets

CASAColumbia Program and Provider Evaluation NY Managed Addiction Treatment System (MATS) NJ Medication Assisted Treatment Initiative (MATI) NY Health Homes NY Screening, Brief Intervention, & Referral to Treatment (SBIRT) NY/NY III Supportive Housing Child, Adolescent, and Family Treatment Research

CASAColumbia Treatment System Reform Initiatives in New York Collaborating with OASAS on Managed Addictions Treatment System evaluation Collaborating with OASAS to develop tools for negotiating level of addictions care decisions: LOCADTR Collaborating with DOH, OASAS, AIDS Institute and OMH on evaluating Health Home and other Medicaid reform efforts Collaborating with OASAS and large healthcare system to implement substance use screening and interventions Collaborating with ASAP on Medicaid Carve-in rollout

Opportunities and Optimism Historic Time of Transformation – not since the 1960s has the healthcare system created this grand of an opportunity for system improvement Our services could be more available to more people than ever before Managed Care and Value-Based payment can encourage creativity and promote quality New business can grow while critical, specialty services find new recognition and reimbursement The vision calls for stronger integration with other healthcare partners

NYS Healthcare Medicaid is the largest State budget item: $62B NY has been leader in extending health insurance coverage to indigent citizens NY provides broader set of benefits than other states NY has been leader in supporting addiction treatment through Medicaid NY Medicaid Redesign Improve quality of care in a more cost efficient system Focus on reducing use of inpatient and emergency department services SUD treatment system essential to accomplishing Medicaid redesign goals

Medicaid Redesign Team (MRT): Principles Guiding Reform Person centered care Recovery-oriented systems that address the chronic nature of behavioral health conditions Treatment and recovery support services that are well-integrated with other healthcare Data-driven decision making in treatment and in rewarding quality of care Treatment that is evidence-based

Managed Care Opportunity to Support SUD System Change Improve care for all levels of SUD severity System needs reform across the continuum of SUD severity No effective private system for low severity Build more state-of-art clinical operations Workforce enhancement Evidence based treatment Medically informed Stronger integration with other systems of care

Managed Care Opportunities to Support SUD System Change Fortify outpatient system Improve engagement and retention Increase integration of medical interventions (e.g., withdrawal management, medication assisted treatment) Expand service offering (e.g., services in the community) Redesign residential treatment system to be better integrated into healthcare system Home & Community Based Services for important subset of treatment population

MCTAC Training, consultation, and educational resource center for all mental health and substance use disorder providers in New York State Provide training Quality improvement strategies Business/administrative Organizational Clinical practices Support with the transition to Medicaid Managed Care

MCTAC for SUD

MCTAC Partners

MCTAC Training Offerings MCO Contracting Business Operations Billing Cash flow management Revenue cycle management Utilization management Level of care: LOCADTR Medical management Medical necessity Length of stay Clinical outcomes

MCTAC Supports for a Value-Based System of Care Financial/ Administration Clinical/ Operations Strategy Business/administrative Financial Management Data Based Decision Making Clinical reform Evidence Based Practices Integrated Care Strategic visioning How can organizations meet the ‘Triple Aim’ How do organizations fit within a larger system of care (e.g., DSRIP, Health Homes, ACOs)

CASA-MCTAC 2015 Upcoming Events Home & Community Based Services Training Starting 10/20/15 through Fall Utilization Management Webinars / Applied Learning Discussions in Fall 2015

CASA-MCTAC 2015 Upcoming Events Residential Redesign Learning Communities for NYC & Long Island Providers: Start 10/21/15 and 10/22/15 Upcoming web based learning modules that will incorporate content experts in OP Withdrawal Management and Medication Assisted Treatment In 2016, Learning Communities for Outpatient Clinics (822.4), Opioid Treatment Programs (822.5), etc. Geographic offering in line with Medicaid rollout

How to learn more… Visit MCTAC’s website for more information and access to past webinars and trainings on contracting, billing, utilization management: MCTAC.org or email: MCTAC.info@nyu.edu For information on future SUD clinical initiatives, email casainfo@casacolumbia.org

Ending Addiction Changes Everything www.casacolumbia.org