endobj MARCH 2016 2 • 5732/1519 performance measurement development process • Measures selected for use with AAAs and BHOs • Measures selected for use in HCA MCO contracting –Mental health service penetration rate –Substance use disorder treatment penetration rate –Psychiatric hospitalization 30-day readmission rate Only qualified professionals that meet our professional standards are included in our contracted provider network. 886 0 obj eInsight is a web-based data platform developed specifically to meet the needs of behavioral health providers. The purpose of the Quality Improvement Performance Plan (QIPP) is to provide a working document for the monitoring, implementation, and documentation of efforts to improve delivery of services to VCBH consumers. 13 2013 QM Program Evaluation: Access to and Availability of Care One way that MBHP measures how well we are doing is endstream %PDF-1.7 The medical provider will instruct the Soldier to go to the BH station at that location. Health Care Service Corporation, Inc. (operating through its five divisions: BCBS of Illinois, BCBS of Montana, BCBS of New Mexico, BCBS of Oklahoma, and BCBS of Texas) Behavioral Health Care Management program has been accredited for Health Utilization Management since October of 2012.This accreditation covers the Behavioral Health Utilization Management program for … Behavioral Health Benefits. However, public health surveillance for behavioral health in the United States has been hindered by organizational issues and other factors. Members can also call Healthy Blue at 1-844-227-8350 for help getting specialized behavioral health care. <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 960 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> If needed, the Soldier will be referred for follow up evaluation. Behavioral Health Performance & Clinical Quality Measures May 28, 2019 National Council for Behavioral Health Montefiore Medical Center ... For provider continuous quality improvement projects c. Managed care organization performance improvement 3. A nonprofit organization founded in 1979, Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage. <> Providers, our Provider Training webinar was held on Thursday, June 25, 2020. The Behavioral Health Home shall submit the SMI evaluation packet within seven days of the Urgent Engagement assessment to the designated SMI Evaluation provider, Community Response Network (CRN). Starting July 1, 2020, Comagine Health has assumed responsibility for assessments from the current contractor, KEPRO. During surveys of both psychiatric hospitals and behavioral health organizations, issues continue to arise around how the organization is assessing the competence of its clinical staff. Accountability a. The purpose of the Healthcare Provider’s Practice Guide for the Utilization of Behavioral Health Technicians. }���G���xY�����a~1y�"�l�:��x2_S��lUnR��^���3��^|�ـ�*^!� ... 2013 QM Program Evaluation: Behavioral Health Provider Satisfaction. Community Care | Behavioral Health Organization. �]j�K���W1��������ă�u�NI�$�2(MJ1 �0������j6[I=���#����W���j�H�M behavioral health (BH) and 343 developmental disabilities (DD) providers. endobj <> After years of development, eInsight now includes the outcomes measures and assessment tools most commonly used in behavioral health organizations. Behavioral Health Homes must maintain capacity to travel to locations within Arizona to complete Urgent Engagements. 3 0 obj 8. d100C��� � H�� If a Healthy Blue member is dealing with depression, anxiety or a mental health concern, our care managers will work with the member and their primary care provider to help get the care they need. Process Steps: a. stream Designated Behavioral Health Care Practitioner UM/PN 40% Chief Compliance and Operations Officers Com/Ops 15% QAPI = Quality Assurance and Performance Improvement PN = Provider Network UM = Utilization Management IT = Information Technology SWMBH will have appropriate staff to complete QAPI functions as defined in this plan. Measure, monitor, and continuously improve performance of behavioral health care in key aspects of clinical and service quality for members, providers, and customers; 7. )$}���B;Fc���I�FB����װ �_�0t)'�0���efᤂ�0�w��pt4�M�O@��d Soldier needs an evaluation (See box A for conditions that warrant CDBHE) Is this an emergency? 1 0 obj The medical provider Credentialing The following Behavioral Health Credentialing forms can be found on Superior's Provider Forms webpage , under the CREDENTIALING section. These indicators provide the drive for health institutions to do better and to submit timely reports of progress. 5 0 obj x��V�k�0�n��p��4E:�� ���[�A�v �1��dvb���qW���d���ҹi��K�{�ݓt�uS�颁�l <. <> endobj From our school mental health quality assessment and resource library, to custom reports and a library of free and low-cost screening and assessment measures, SHAPE has the tools teams need to improve school mental health programming and sustainability in schools, districts, and states/territories. Value-Based Behavioral Health Care. Document Purpose and Philosophy This manual serves as a guide for providers within the Community Behavioral Health (CBH) network. endstream • Behavioral Health Provider Satisfaction ... We are centered on improving performance, building strong leaders, and enhancing organizational effectiveness. The National Committee for Quality Assurance (NCQA) rates health plan performance against key measures. x���=kd���o���ܥ�ƽ�KcT�P��6jR��$ l���²`A@�B!�$�-;�H� ��H�j|؃�7ݑf�����A�Fs�ܙm�p��{t �N��o� @k!I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I�$I��_?���_���b#��Ͼ�j��������=�������ы/��(I�$i��1�w��c��F��8��������>��~��$I���m�jJ�;�R���rJ�ߔ/�ec�xM��y�XO��Sb�����2ǟ�z����cN>SR-��^��zjU1�-�O I�$i�ڎA���o&v'u�Y��?�]H1��g畹��b���j���r8�ɨ�&'CI�$I��vJ1��ޟ+| c��Φ�:����w`��O��\a$I�$�O�1(�e:'-���w�dOS��3@�yR��I�$I��vJ�+'\�{����Յ#�;���cK�$IҚdP�&��E�P��=Gc�H�$Iڠ�cP�;(���1����5&.|76����:J�$I���R]qn�1oyG���R�ڠ4Ơ$I�$�a����g�����^݊߼�|U���˃�Az�>�3�M=5����$I�t���Y�_��G?�ӭ�YiU���↳�W�k�[�Ƹ�y~�A�.���I�$I�u��R�"u��|йKlV;�fJ����-�$I�� �J���w1��t�����g/��yϣ)����R�}�U]��3@MJu�],R���r��$I�����Ai��J��q&�S�T�q)wŃ�>C;�L_�a���'%I�$�V�����������Is���qgr�Y)^ЎH�K(ē�{hqq|�����x�*V�V��$I��v�%I�$I̠$I�$I�J�$I��ɠ$I�$I�J�$I��ɠ�=~����'{�����"�7Օ$I�4�Ai#�;:�=���^��*��e��X�Q�$Iڞ�Ԡ��1����ٍ}�������w��j��M���S,x#(I�$mU+�~�ã������t�4}��ۭ��hq�ƶypI�$I���A��?��'���RnxP���USF��}�+i͇;I�$iC�S�R��)#���wN��g=�_�B 14.1.2 Capacity to Travel. Evaluation, Therapy and Training. Produce actionable, valid and reliable data to drive decision making resulting in <> In considering changes to performance measures and other aspects of the behavioral health system, communication with and input from stakeholders is critical. endobj 904 0 obj PURPOSE. ePortal; Provider OnLine; Community HealthChoices. Effective November 1, 2017, behavioral health functions transitioned from Cenpatico (a subsidiary of Envolve PeopleCare) to Superior HealthPlan. �U��L�Ua������ ��������������Ѡ�������d�0�)FW �ļ`�3�3������F���� ��9�(20:�iN�\ ���r H�00����L� ��>H INTRODUCTION 1.1. All Performance specifications are located online at tuftshealthplan.com in the Provider Resource Center. %���� Our performance as a health plan is a direct reflection of your performance as a provider. endobj 887 0 obj Behavioral health clinicians, peer support specialists, health care professionals, community agencies interested in supporting behavioral health, consumers and family members will gather to hear about the status of behavioral health in North Dakota and learn from … �;��H�c�k�j�G���U¦�5M-[%Ur�,�|%�a�r��.�#d�4�'y����3>�ݼY �6�vF`DQI�=hϪMÕ#���~�E?&�y�?�p�H��J����~�hكi)I�J �z�>��]EHx�n����4) ��!�����ϲ�P�Y��!ƴ!8'�~�f7@~層u������~��I4����y�������P�6d���h���O:>�t,�R�v�����:�iM4��CǜU�c��8��_�����RWTo�jI�b��P����̀�M�b�$B���E:�zM��DW�zG���"5�1�_F;����uڴIc��~R�dR|QR�tb��긶 �:�A/������ The plan offers members and employers an array of health management programs, which support evidence-based approaches to health … %PDF-1.5 %���� 2. CDR receives . The importance of KPI reporting for behavioral health is undisputed. With Blue Premier Behavioral Health, behavioral health providers earn incentives in addition to their current fee-for-service billing when they help patients gain quick access to care, coordinate their efforts with primary care providers (PCPs), and most importantly, help patients improve. How members access Behavioral Health services. A key aspect of engaging stakeholders is providing them with robust and easily understandable information regarding the behavioral health system and its providers. h�b```�tfv>~�g`C�&���Ϙ_00�|dJ�;���L����������*M��;3�v<6�}�̴�Ն�, We have seen several survey findings for organizations not clearly defining competencies and not having a process for ongoing evaluation of clinical competencies. 2 0 obj Through Magellan, we provide a broad, diverse network of experienced behavioral health providers, as well as expert case managers working with AvMed clinical staff to coordinate your patient's care. <>/Filter/FlateDecode/ID[<8B5795DE99ADB2110A0030EE9173FE7F>]/Index[886 19]/Info 885 0 R/Length 58/Prev 100711/Root 887 0 R/Size 905/Type/XRef/W[1 2 1]>>stream Provider Resources. For … So, in this article, we are […] BH provider recommendations (See box B for minimum recommendations) CDR discusses with BH provider. A portion of these data are reported in this QM Program Summary. Innersense Behavioral Health provides a full range of therapy and evaluation services to children, adults, couples, and families. Purpose. Community Behavioral Health Provider Manual | November 19, 2020 | 7 1. We're working together with Magellan Healthc are to provide our Members with integrated behavioral healthcare solutions. The Provider Evaluation of Performance (PEP) Plan details the content of the audit processes that will be utilized during a review so that Providers will have a summary of the requirements which may be utilized to review their own performance and implement change. g��? Y�@��#E��d�1k��=X��_��Z/wE?�4f)G�n�[�1]� rä�a2�_�A=R�(%��{�D�[V Improve member and provider satisfaction with the health plan services; and 4. In 2015, more than 27 million people in the United States reported that they currently used illicit drugs or misused prescription drugs, and more than 66 million reported binge drinking during the previous month. 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