1. 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

2. 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)

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. MCTAC for SUD

14. MCTAC Partners

15. 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

16. 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)

17. 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

18. 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

19. 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 For information on future SUD clinical initiatives,

20. Ending Addiction
Changes Everything