How to Form & Operate a Managed Care Steering Committee Shelley Smith & Jesse Vick – West Texas Centers

Learning Objectives Importance of forming an internal Managed Care Steering Committee (MCSC) Who should lead the MCSC? Who should be on the MCSC? How do the committee meetings work?

Which Centers currently have an internal Managed Care Steering Committee?

Importance of Forming an Internal Managed Care Steering Committee (MCSC) Brings focus to managed care Shift from General Revenue as primary funding source Provides future direction of health care industry Illustrates the effects of managed care on all aspects of the business Helps everyone see how the actions of each department impact others

MCSC as It Relates to Revenue Cycle Management All areas of business are affected – challenge department managers to understand their connection to the process Not limited to reimbursement, accounting or financial Services Contracting, credentialing, systems configuration, hiring, accountability, and training are the foundation of Revenue Cycle Cultural impacts: Tone from Executive Team Integration with all other planning and meetings Job descriptions Performance reviews Corporate communications

Who Should Lead the MCSC? Senior level manager who: Has broad understanding of different areas of the organization Introduces and implements principles from the business world Challenges all levels of leadership to self-examine Confronts “No” on a routine basis. Challenges current thinking Understands this is a cultural shift for the entire Center Has 100% support of CEO CEO ensures that Executive Team views MCSC Chair as a person of influence

Who Should be on the MCSC? Focus on roles not titles. Chief Executive Officer (CEO) – brings authority and priority Chief Financial Officer (CFO) – financial impacts Chief Operating Officer (COO) – workflow and resource impacts

Who Should be on the MCSC? Chief Information Officer (CIO) – technology design and demands Chief Strategy Officer (CSO) – keeps an eye on the future of the industry Managed Care Director – relationships with payers

Who Should be on the MCSC? Chief of BH – patient experience and recovery, program staff oversight Chief of IDD Services – consumer experience and recovery, program staff oversight ECI Director – family experience and recovery, program staff oversight

Who Should be on the MCSC? 1115 Director – experienced with projects, quality measures and cross-disciplinary collaboration HR Director – job descriptions, performance evaluation, and hiring impacts MIS Director – data design and information extraction

Who should be on the MCSC? Quality Management – audits and corporate compliance Credentialing Specialist – billing and service delivery impacts Reimbursement Representative – billing impacts

Differences Due to Center Size Org chart length

How do Committee Meetings Work? Schedule Meet monthly 3 ½ to 4 hours 15 minute break Considering lengthening meeting with intro of CCBHC Twice per month, or One six-hour meeting with catered lunch

Agenda Typical agenda

Curriculum Months 1 – 2: Define committee purpose, roles and structure Months 3 – 8: Present each area of business using segments of Revenue Cycle Management Model as the guide

Curriculum Credit: Martin Cook, Director of Reimbursement Management, Austin Travis County Integral Care

Curriculum Month 9: 1115 Waiver updates Month 10: Outside work products MCO Contracting Questionnaire Western Behavioral Health Network Work Plan Month 11: Action planning for future

Curriculum Month 12: CCBHC measures Month 13: Client experience; crisis billing & collections Month 14: Value-based payments and CCBHC

Future Curriculum Months 15 – 21: Update job descriptions and performance evaluations to align with MCO contracts Value-based payments CCBHC

Breakout Session What are your Center’s most significant barriers to forming an internal MCSC? What are some potential solutions to those barriers? If you have an internal MCSC, what impact has it had on your Center’s operations?

Questions Shelley Smith, CEO for West Texas Centers shelley.smith@wtcmhmr.org Jesse Vick, CSO for West Texas Centers jesse.vick@wtcmhmr.org