Let’s Make A Deal

Milwaukee County Behavioral Health Division

Milwaukee WIser Choice

November 2010 – July 2011

The Convener Team

• David Moore - Coach • Janet Fleege – WIser Choice Project

Director/Convener• WIser Choice Providers:– ARCW -Benedict Center– Brighter Days -Empowerment Clinic– Guest House -Harambee/IMANI– Horizon, Inc. -Meta House– Recovery Network -United Community Center

Project Description• This collaborative supported the

work of preparing 10 providers for healthcare reform in 2014–Medicaid track (5)• Aim was to become Medicaid

certified

– Increasing billing revenues track (4)• Aim was to increase already existing

revenue sources

–One wasn’t able to complete (1)

Activities• 2 Face to Face meetings– Outside of Kick Off meeting– Coach was able to attend due to close

geographic proximity

• Project conference calls– 2 tracks, focused on unique needs of

each group– Ended with group call to support the

work accomplished by each provider and to share lessons learned

Activities cont.• One-on-One Coaching Calls– Providers benefited from individually

identified support from coach and/or convener

– Change project charter forms used to monitor progress and keep on track

• Focused training provided– Medicaid 101

• An introduction to CPT & ICD-9 codes• Medicaid modifiers and fee schedules• Overview of Forward Health portal• Claims processing

Activities cont.• One-on-one meetings with

Agency Directors (when requested)

– Help ‘ask’ the right questions to further project progress

• Remove internal agency barriers

– Support, encourage, validate work being done on behalf of fee for service initiative

Medicaid Track

• Medicaid Track– Start from beginning• Searching to see if they had an NPI #,

obtain one if they didn’t

– 4 of 5 obtained Medicaid certification• One agency had several staff enroll in

college to pursue degrees in Social Work/Human Services

– One project experienced a 62% increase in billable revenue

Increasing Billing Revenues Track

• Of the 4 providers– All had at least 2 contracts outside

of Medicaid– All in various stages of billing• Searching to see if they had an NPI #,

obtain one if they didn’t

– Created new internal audit sheet to capture and monitor collection

Lessons Learned• As a convener– Strong relationships with providers– Much to learn about medicaid certification and

billing as well as 3rd party revenue sources • Providers weren’t aware of their own bottom

line– Heavy emphasis on county funding– Need to decrease dependency of county funding

and increase 3rd party billing– More hopeful• We can do this!

Lessons Learned, cont.

• Strong group of providers who can mentor others– Strong value in working with other providers and

learning from each other, to encourage other providers• Cross pollination• There is no competition• The need will always be there, but we may not be• Not necessary to recreate the wheel

Lessons Learned, cont.

• Existing relationships needed strengthening– Providers did not have strong relationships

w/contractors • Marketing, Marketing, Marketing– We’ve been around, people know about us• Changing world, changing climate, changing field

– Need to respond to change

No longer one door!

• Door 1-WIser Choice/County• Door 2-Medicaid• Door 3-UBH• Door 4-Icare

• > # of Doors – greater choice