1. Psychiatric Transitions in a Managed Care Environment

2. Panel Agenda Brief Introductions Responsibilities of Managed Care Plans What type of Care Management does a Plan provide? What is the Plan’s role during transitions in care? Common Barriers and Collaborative Solutions How to Contact Us

3. Responsibilities of Managed Care Plans

4. Provide access to a wide range of providers Increase communication and information sharing between providers Ensure that members receive quality care Improve coordination of care for all members MCP Responsibilities

5. Care Management Model in Managed Care

7. Goals of Care Management Member-driven care planning process Help members regain optimum health and function Promote adherence with prescribed treatment plan Teach self-management skills, encourage preventive care Improve health outcomes and manage healthcare costs Maximize benefits of a medical home

8. Care Management Services Care Coordination Health Promotion Advocacy & Access Outreach Linkage for Basic Needs Collaboration

9. Care Planning and Coordination We are not direct providers Customized based on acuity, supports, needs We are liaisons to make sure the dots are connected by the treatment team We can provide data and supports that will help the treatment team

10. Care Management Process O utreach to members who are stratified to address safety, behavioral, and/or medical issues or social service needs Assess needs, barriers and gaps in care Create an individualized care plan outlining problems, goals and needed interventions while emphasizing safety and social needs Regular follow-up in order to coordinate care, provide resources and guidance to improve health and well-being Encourage adherence to treatment plans and motivate members to learn self-management skills

11. Transitions of Care in Managed Care

12. Transitional Care Facility visits to engage member and clarify discharge plan Authorization of services as needed Assessment and plan for transition needs Coordination of aftercare appointments Home visits, assessment of support system Medication reconciliation Monitoring of adherence to discharge plan

13. Common Barriers and Collaborative Solutions

14. Common Barriers during Transitions Access to members during inpatient stay Timely access to discharge plan Access to aftercare services within first week of discharge Exchange of information between providers

15. Collaborative Solutions ED access for diversion, placement assistance, and discharge planning Facility access and ongoing communication on member needs and discharge plan Hospital liaison services on day of discharge and regular medical aftercare appointments Crisis planning in ongoing care management for high utilizers

16. CARESOURCE Terry R. Jones Phone: (937) 286-3985 Email: Terry.Jones@caresource.com BUCKEYE HEALTH PLAN (CENPATICO) Stephan Young Phone: (866) 246-4356 ext. 24510 Email: styoung@cenpatico.comEmail: styoung@cenpatico.com UNITED HEALTHCARE (OPTUM) Mike Mesewicz Phone: (614) 410-7358 Email: michael.mesewicz@optum.com How To Contact Us PARAMOUNT Hy Kisin Phone: (419) 887-2251 Email: Hy.Kisin@Promedica.org MOLINA HEALTHCARE Emily Higgins Phone: (614) 212-6298 Email: Emily.Higgins@MolinaHealthcare.com AETNA BETTER HEALTH Afet Kilinc Phone: (614) 933-8334 Email: KilincA@Aetna.com