welcome to the magellan provider town hall webinar · principles of stakeholder engagement people...
TRANSCRIPT
Welcome to the Magellan Provider Town Hall Webinar
December 12, 2017
Survey for today’s Town Hall
Attendance Survey: To assist us in taking attendance at today’s webinar, please use the survey monkey link provided for that purpose.
Feedback Survey – Please also complete the 2nd
survey, to provide your feedback on today’s presentation and to give us your suggestions for future presentations. The topics for today’s webinar were based on feedback we received from you at our previous Town Hall.
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Agenda
Website updates – Aubrey Proud [email protected]
PCPC to ASAM update – Anita Kelly [email protected]
Routine provider oversight – Karli Schilling [email protected]
Screening tools– Dr. Rajiv Vyas - [email protected]
Magellan Member Advisory Workgroup - Willie Korman [email protected]
Ordering/Referring/Prescribing (ORP) - Scott Donald [email protected]
Network updates – Jeff Stumm/Mitch Fash/Crystal Devine
Presentation: John Lees & Tom Walker
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Website updates
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We will release updates to our current website on approximately Jan. 19, 2018
www.magellanofpa.com will remain our website address. However, all other URLs to current pages will get updated. As such, we encourage everyone to visit the new site after the update is launched to navigate around and set up any bookmarks, etc…
These updates will include:• Branding consistent with www.magellanhealth.com
• Two homepages: one with a member focus and one with a provider focus
• Mobile responsive features for phones, tablets, etc…
• Improved navigation
• Accessibility that is fully compliant with Act 508 regulations
For Members Homepage
The new ‘Main Menu
Options’ choices will be:
1) Find a Provider
2) Member Resources
3) Services & Programs
4) Community
5) Health Library
6) County Info
The new ‘Ribbon Tabs’
choices will be:
1) Get Started
2) Recovery & Resiliency
3) Community Events/Resources
OptionsMenuMain
TabsRibbon
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For Providers Homepage
The new ‘Main Menu
Options’ choices will be:
1) Provider Resources
2) Provider Communications
3) Services & Programs
4) Community
5) e-Learning Center
6) County Info
The new ‘Ribbon Tabs’
choices will be:
(will change to 3 across)
1) Get Started
2) PA HealthChoices
3) Compliance
OptionsMenuMain
TabsRibbon
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About Us
The new ‘About Us’ inclusions will be:
1) Overview
2) Mission Statement
3) News Releases
4) Magellan Cares Foundation
5) Careers
6) Nondiscrimination and Languages
7) Contact Us
UsAbout
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PCPC to ASAM
-Info from the State addressed in November 22nd letter from DDAP Acting Secretary, Jennifer Snyder
The Change Company will provide all training in a 2-day, in-person training
Still on track for full implementation on July 1, 2018
DDAP does not have funds to pay for effort of this magnitude
-All providers should have received questionnaire from Magellan asking for number of employees needing ASAM training
-Magellan and counties working together to help agencies meet deadlines and funding
-Updates from Dec 5th RCPA D & A Committee Meeting
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Routine Provider Oversight
Overview
Consistent Approach
Proactive Patient Safety activity
Monitor adherence to Standards
Audit Types:
Treatment Record Review
On-site/ Targeted Review
Integrated Audit
2018 Methodology for Provider Selection
Statistically Valid Random Sample
Rationale for Changes
Diminish administrative burden on providers
Balance number of audits required annually
All provider types and sizes subject to routine oversight
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Screening Tools
Magellan has selected two screening tools as resources for providers:
1) GAIN SS (screening for dual diagnosis):
• A brief 5 to 10 minute instrument designed to quickly and accurately screen both adults and adolescents for substance use and mental illness.
2) PHQ 2 (screening for depression):
• A two question screen for depression.
More information about these screening tools is available on the Magellan
of PA website:
• http://www.magellanofpa.com/for-providers-pa/provider-communications.aspx
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How did Magellan select these tools?
Based on reasonable scientific evidence adopted from nationally recognized behavioral healthcare organizations that have developed guidelines.
Based on scientific and research literature.
Based on best practices from industry standards or expert opinion with proven reliability.
Magellan evaluates its screening programs annually and welcomes provider feedback to determine if they need to be modified or changed.
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Benefits of screening tools
Screening tools support providers in identifying members who needsupport.
Screening tools support diagnosis, treatment, and recovery.
The tools selected are brief and easy to understand.
The tools selected require minimal training.
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Magellan Member Advisory Work Group
Member Advisory Work Group Introduction
The Member Advisory Work Group meets quarterly. The group’s feedback will be used to review internal policies at Magellan. The work group committee is composed of Members, Family, Peers, Stakeholders, & Community Groups. Our county partners are made aware of this work group and asked to assist in alerting member and family to participate.
The purpose of these meetings is twofold:
• Obtain feedback on items discussed during meeting
• Take the feedback and apply it to Magellan procedures
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Magellan Member Advisory Work Group
Objectives:
• Review of and comment on the written provider accessibility and availability standards, conclusions, recommendations, and actions taken.
• Review of and comment on design and implementation of the Magellan Behavioral Health of Pennsylvania screening programs.
• Review of and comment on any clinical practice guidelines as appropriate.
• Review member experience survey annual results and member experience activities, including satisfaction with the UM process and member access.
• Review of and comment on Magellan Member Rights and Responsibilities Statements and other member communications, such as written information for consumers on services and benefits.
• Review of and comment on the selection and evaluation of relevant clinical or service Quality Improvement Actions (QIAs).
• Review of and comment on Care Management Center (CMC) procedures for customer complaints and appeals and/or frequent complaints/ appeals.
• Review Recovery/Resiliency and Patient Safety Program activities and initiatives.
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Ordering, Referring, and Prescribing (ORP)
ORP – What is it?Ordering, referring and prescribing is being done to comply with program integrity provisions of the Affordable Care Act (ACA), which states that the State Medicaid agency must require all ordering or referring physicians or other professionals providing services under the State plan to enroll as participating providers effective January 1, 2018.
What you need to do: Actively work with impacted practitioners who Order, Refer, and Prescribe for your agency to ensure
their enrollment is active with PA Medicaid. Information regarding the DHS enrollment process and electronic applications can be found at:
http://www.dhs.pa.gov/provider/promise/enrollmentinformation/index.htm Ensure that your claims systems and processes are able to include ORP information on all of your
claims for dates of service starting January 1.
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ORP – Continued
Resource Materials
To access all of the information related to ORP including the link to the State's technical specifications for outpatient and institutional billing and the levels of care that require ORP submission, please visit the ORP page on our website.
Claims Processing Post January 1
Providers are REQUIRED to include ORP information on claims for dates of service starting January 1. Claims will not deny on day 1 as we monitor compliance to this new requirement. Magellan will notify providers in writing if your claims do not contain ORP information and or your ORP practitioner is not enrolled with MA.
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Network Updates
Provider Search Tool
Updating location moves and MA enrollment
Claims submission and follow up
Jeff Stumm: [email protected]
Crystal Devine: [email protected]
Mitch Fash: [email protected]
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Voice to Vision to Action: A stakeholder engagement toolkit
December 12, 2017
John Lees, LSW [email protected]
Tom Walker, MA [email protected]
Learning objectives
• Understand the guiding principles of stakeholder engagement as applies to adult behavioral service recipients, children and adolescents with serious emotional disturbance and/or substance use disorders and their families
• Review strategies implemented by Magellan Behavioral Health of Pennsylvania (Magellan) to increase its stakeholder engagement:
− Best practices
− Key lessons
− Implications for continuing work
• Develop/Discuss a model of systems change through the lens of three interrelated components:
− Strategic direction
− Stakeholder engagement
− Data-driven decision making
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Agenda
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Principles of stakeholder engagement
How to engage stakeholders
Methods and results
Questions
Principles of stakeholder engagement- stakeholder centr ic ity
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Source: “In Less than Ten Weeks, WhyData’s Ability 1.0 Service Experience Analytics Platform Uncovered over $28 Million in Cost Savings for This Top Ten US Bank.” WhyData, 4 Dec., www.whydata.com/case-study/in-less-than-ten-weeks-the-whydata-analytics-platform-uncovered-over-28-million-in-cost-savings-for-this-top-ten-us-bank/
Principles of stakeholder engagement
People affected by mental and substance use conditions have a central role to play in shaping the programs and policies that serve them. This includes people with lived experience of mental illness and family members.
According to Mental Health America, “The participation of stakeholders in aspects of mental health and substance use planning, advisory and governance boards is essential to the effective planning, delivery and evaluation of such services.”
Source: “Position Statement 63: Participation in Mental Health Planning, Advisory and Governance Boards.”
Mental Health America, 16 Mar. 2015, www.mentalhealthamerica.net/positions/advisory-boards .
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Agenda
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Principles of stakeholder engagement
How to engage stakeholders
Methods and results
Questions
How to engage stakeholders- Scope of work
• Choose the model for stakeholder engagement − 1:1 Interviews in the field; Focus groups; Direct/Indirect surveys
• Put together a winning team
− Technical/Subject matter experts
− Marketing/Communications
− Peer services/Parent partners
− Administrative support
• Define concrete objectives
− Innovation is the goal
• Incentivize participation
− Be able to answer two questions, “What do you need from me?”; and, “What do I get out of it?”
• Target stakeholders− Look to where your existing and strongest relationships are and build from this vantage
− Include those who may play a pivotal role in helping planning efforts succeed or fail, as well as primary clients, systems partners, and community partners
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How to engage stakeholders- Scope of work
• Plan the logistics− Marketing and promotion, scheduling, careful choice of venue, plan for registration,
develop information-sharing strategies and ground rules, make necessary and reasonable accommodations, consider safety and inclusion, transportation, healthy food
• Develop a timeline
• Plan for resources (direct and indirect costs)
• Assign a scribe/plan for documentation
− Keep track of and document minutes. Ensure there is an agenda, minutes, and that new materials are prepared and available at each meeting. Bring more than you think you will need.
− Protect and strictly maintain confidentiality.
• Be clear about how the results of engagement efforts will be used and disseminated
• Define criteria for success and follow-up
• Publish and promote results, ensure the mechanism for continuous improvement
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How to engage stakeholders- Tools to tr igger & support social innovation
Principles of Innovation
− Look ahead
− Develop a clear plan
− Clarify priorities
− Collect input from others
− Know the people I’m working with
− Generate new ideas
− Test and improve
− Sustain and implement
http://diytoolkit.org/tools/evidence-planning-2/
http://diytoolkit.org/tools/swot-analysis-2/
http://diytoolkit.org/tools/problem-definition-2/
http://diytoolkit.org/tools/fast-idea-generator/
http://diytoolkit.org/tools/critical-tasks-list/
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Source: NESTA (2014) DIY: Development and impact you : practical tools to trigger and support social innovation, London, National Endowment for Science, Technology and the Arts (NESTA).
Agenda
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Principles of stakeholder engagement
How to engage stakeholders
Methods and results
Questions
Methods and resultsVis ion of Magel lan’s services counci l meetings
Magellan established consumer/family advisory councils to offer HealthChoices members an opportunity to take an active role in providing feedback, increase access to services, identify innovative solutions, and improve the overall quality of behavioral health services available to members.
Discussion topics included:
• Evaluation of service and program quality;
• Review and evaluation of membership information (including handbook, newsletters and other means to distribute information);
• Identification of service gaps;
• Identification of program investment opportunities and involvement of members on committees including RFI committees;
• Other topics of interest
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Methods and resultsVoice of Magel lan’s services counci l meetings
The most important topics:
• Employment
• Housing and the impact homelessness has on mental health stability
• Communication with providers
• Alternatives to psychiatric services, especially peer support
• Access to care and more generally awareness of services
• Physical health (Wellness, Dental)
• Accessing information on mobile devices and expanded social networks
• Better understanding of the workings between physical and behavioral plans under HealthChoices
• Transportation
• Education and training of professionals
• Support and education for parents; better support in times of transition for youth
• Assistance with navigating services
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Methods and resultsAct ion of Magel lan’s services counci l meetings
Steps taken to improve planning, delivery and evaluation of services
Examples:
• Autism Action Committee and 3-year plan
• Family navigation guide
• Family training
• Customer service associate soft-skills training
• Technology solutions/mobile phones
• Member and family advocate
• RFIs for Specialized Peer Services, Consumer/Family Satisfaction Teams, and Specialized Outpatient Services
• Provider learning community/networks
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Methods and resultsAction of Magel lan’s services counci l meetings
Best practices:
• Promotion: snowball sampling was the most effective method of recruitment.
• The use of existing services groups, as well as more neutral community locations were attempted. Attendance is better when connected to a community hub.
• Magellan's Supervisor of Recovery Services facilitated discussion.
− Modeling appropriate disclosure through an icebreaker exercise is a key component of every session
− Minutes are reviewed at every meeting
− Common language – technical concepts broken-down into component parts
• Magellan enlisted the Consumer and Family Satisfaction Team to assist with the Advisory Council for adults, and school-district staff (parent partner) with families. Having a third-party assist typically provides the most objective results.
• Staff members as well as providers were available and ready to assist with navigation of services and to meet individual services needs expressed.
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M e t h o d s a n d r e s u l t s
Action of Magel lan’s services counci l meetings
Best practices (cont.):
• A monetary stipend was paid to members serving on the Councils.
• Bus tickets were provided to assist with transportation.
• Spanish language translation of all printed material, as well as live interpreting services enabled members with limited English language proficiency the opportunity to fully participate in council meeting topics.
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Agenda
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Principles of stakeholder engagement
How to engage stakeholders
Methods and results
Questions
Survey Reminder
Your feedback is extremely important!
Thank You!
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Confidentiality Statement for Providers
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The information presented in this presentation is confidential and expected to be used solely in support of the delivery of services to Magellan members. By receipt of this presentation, each recipient agrees that the information contained herein will be kept confidential and that the information will not be photocopied, reproduced, or distributed to or disclosed to others at any time without the prior written consent of Magellan Health, Inc.