Arizona BH Payment Reform Toolkit Provider Readiness Self-Assessment Orientations: March 16 and 18 Dale Jarvis, CPA Karen Linkins, PhD Jennifer Brya, MA, MPP 1

Format for Today’s Webinar I will walk through slides and jump in and out of Survey Monkey. If you have questions: – Type in a question in the Questions dialog box – And Press Send You can also Raise Your Hand if you want Your question answered ASAP. 2

If the Webinar Dialog Box… Is covering too much of your screen 3

If the Webinar Dialog Box… Press the Red Arrow To Minimize the Dialog Box 4

Now, on to the Orientation… 5

What we learned at the Boot Camp 1.Change is coming to the Arizona behavioral health system. 2.Payment reform readiness preparation needs to begin now. 3.A Provider Readiness Self- Assessment and Key Informant Interviews with RBHAs and the State are the next steps in the process. 6

What we learned at the Boot Camp 4.We think the Arizona public behavioral health system of care will benefit from moving into payment reform in four phases. 7

What we learned at the Boot Camp 5.We think the RBHAs and Behavioral Health Providers have 2 to 3 years to demonstrate that they can accelerate movement toward the triple aim for Medicaid enrollees with BH disorders. 6.Otherwise, some portion of the ecosystem may be…. 8

Phase 1 – Payment Reform Preparation Key Questions – What readiness gaps do the provider organizations need to close to succeed in Phase 1? – What readiness gaps do the RBHAs need to close to succeed in Phase 1? – Which parts of the work should be cross-RBHA efforts and which belong inside each RBHA? 9

Phases 2 – 4 Will roll out on a yet-to-be determined timeline. Likely over the next 1-3 years. 10

The Provider Readiness Assessment 8 Areas 40 Questions 5 “Station Breaks” To tease out your strengths and areas that you need to beef up 11

What You Need to Do… Step 1: Identify a lead for this mini-project. Step 2: The lead reviews the survey and decides who should be on the ad hoc team to complete the self-assessment (1 hour). Step 3: Give the survey to each person on the ad hoc team and have them read it (30 minutes per person). Step 4: Meet as a small groups to answer as many questions as possible and determine homework assignments to answer the rest of the questions (1-2 hour meeting). Step 5: Everyone complete their homework (1 hour per person). Step 6: Meet a second time as a group to finish the answers and do a final review (1 hour meeting). Step 7: Enter the answers into Survey Monkey (20 minutes). 12

Important Note about Step 7 Survey Monkey is a great tool but has one quirk. Once you begin entering information into the Survey Monkey, you have to finish entering all responses. You cannot enter some of the responses and come back later to finish your entries. 13

8 Sections Section A: General Information Section B: Client Needs and Caseload Management Section C: Access, Scheduling, and Engagement Section D. Clinical Practices and Outcomes Based Care Section E: Integrated Care and Care Coordination Section F: Business Practices Section G: Information Technology Questionnaire Section H: Regulatory Requirements Burden 14

What about the RBHAs and the State We will be conducting key informant interviews with each RBHA and key folks from the state to gather additional information, including: – RBHA Readiness in key areas – What Value-Based Purchasing ideas RBHAs are already working on – Where RBHAs think they should work together on a single design for a particular part of the system – What are the key value-based purchasing components the state would like to see moved forward – How can this effort support the SIM Grant 15

Let’s Look at a Station Break Station Break – Level of Care System Payment reform requires patients/clients to be tagged with a clinical cohort in order to compare quality and efficiency in an “apples to apples” manner. For example, those studying the medical care system would never mix people receiving a knee replacement and people having heart surgery into the same quality and efficiency study. This is more nuanced, but equally important for those with behavioral health disorders. It is not appropriate to mix adults with mild to moderate depression into the same study with adults with a serious and persistent mental illness who are being admitted to a psychiatric hospital more than twice per year. The behavioral health solution, which is being widely adopted throughout the country, is to develop and agree upon a standardized Level of Care System with clear Authorization Criteria, and Utilization Management Guidelines. This clinical cohort framework moves beyond diagnosis, adding other dimensions such as Risk, Functional Status, Co-Morbidity, and Recovery Environment. Without Behavioral Health Levels of Care, it will be extremely difficult to move to value-based purchasing. 16

Let’s Jump Over to Survey Monkey 17

There’s Also a Hard Copy Version 18

IMPORTANT!!! All Survey Monkey submissions are CONFIDENTIAL. We will compile the results, labeling them Agency 1, Agency 2, Agency 3, etc. The Agency Names go into a BLACK BOX and will not be shared outside the consulting team. 19

Next Steps Monday and Wednesday Orientations (3/16, 3/18). Friday 3/20: to All Providers containing: – These Slides – 18 Page hard copy Readiness Assessment – Link to Survey Monkey electronic Readiness Assessment Two Weeks to Work on the Assessment (March 23 – April 3); the submission deadline is April 3, 5pm. Your consulting team will compile the results (April 6-10). Two webinars (repeats) April 14 and April 15 to share Results. Two outcomes of the results: – The Providers, RBHAs and the State will have important information on the readiness efforts needed to succeed with payment reform. – Your Consultants will determine where to go DEEP with Toolkit Information. 20

Questions? Monday and Wednesday Orientations (3/16, 3/18). Friday 3/20: to All Providers containing: – These Slides – 18 Page hard copy Readiness Assessment – Link to Survey Monkey electronic Readiness Assessment Two Weeks to Work on the Assessment (March 23 – April 3); the submission deadline is April 3, 5pm. Your consulting team will compile the results (April 6-10). Two webinars (repeats) April 14 and April 15 to share Results. 21

After Today… If you have ANY QUESTIONS, please contact: – John Freeman: – Bahney Dedolph: If you need ANY HELP, please contact: – John Freeman: – Bahney Dedolph: 22