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

2. 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?

3. Which Centers currently have an internal Managed Care Steering Committee?

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

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

12. Differences Due to Center Size
Org chart length

13. 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

14. Agenda
Typical agenda

15. 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

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

17. 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

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

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

20. 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?

21. Questions Shelley Smith, CEO for West Texas Centers
Jesse Vick, CSO for West Texas Centers