ANCOR is sharing this item from our Friday Weekly Update as a courtesy to our members.
As written by Donna Martin, Director of State Partnerships and Special Projects:
Following a couple weeks of announcements and that summer holiday we all love, its back to writing about the work of the Learning Collaboratives! This week I’d like to tell you about our Business Acumen Learning Collaborative state team from New York. The team is led by representatives from the state Office for People with Developmental Disabilities (OPWDD) and has representation from the Department of Health, Office for the Aging and fifteen CBOs.
Their goal was to establish a collaborative learning project to support the state’s emerging Care Coordination Organizations (CCO)/Health Homes (HH) by expanding the readiness of CBOs that serve individuals with I/DD for operating in a managed care system. The state’s plan was to implement integrated teams across seven regions and encompassing CBOs to provide wrap around health, behavioral health and long term services and supports in a holistic manner. The target date for implementation was 2018 and the state wanted to ensure that the emerging CCO/HHs and corresponding CBO partners had the business acumen, with an enhanced understanding of managed and integrated care functions and business processes, needed to operate in this different environment.
They understood that under future managed care, habilitative outcomes would be linked to value-based payment, and the attainment of individuals’ goals will be quantified and measured. Shifting from what was then a fragmented fee-for-service system to managed care represented a seismic change in how the I/DD system was structured; how the services were planned, authorized, delivered, monitored and reimbursed; and how the array of habilitation, employment, residential services; health and behavioral health care would be integrated.
The NY State Team did accomplish the goals they set out to achieve. The Regional CCO/HHs participating in the collaborative along with several partnering CBOs developed the needed skills identified for a successful transition. These skills included understanding integrated care; learning how to determine costs, pricing and cash flow; the need for customer oriented marketing strategies; how to communicate with health providers; and managing risk as they eventually move into a full manage care environment.