It seems our money is being spent a little smarter these days. Remember Target Cities? A ton of money came into our field about ten years ago with the Target Cities grants. A bunch of professionals were hired and nebulous work was performed, and then the money was gone and Target Cities went away. Tom McClellan mentioned this in his January 12, 2010 talk (now a recorded webinar) to NIATx members. Target Cities went away and I forgot about it. Today’s sweeping change in behavioral health & addictions treatment seems better thought out, driven to produce better treatment outcomes and become self sustaining.
We’ll know how effective it is in about ten years.
New York State’s clinic restructuring is a good idea. It changes every ambulatory clinic in the state, it’s driven by the Office of Mental Health, and the incentive is survival. No single adjustment, or small group of business modifications will be enough to improve business processes and make them profitable. It’s truly a change or die situation in New York.
We work in an amazing time, and are driven to excell, to be better at what we do. Goals for the restructure include: • Create a mental health system that is focused on recovery for adults and resiliency for children • Redefine clinic treatment services • Restructure the financing of the mental health clinic treatment system.
In a great part, these changes will be made possible by updating workflows in clinics: • Concurrent Notes: Clinicians are giving in to writing a note while the patient is in a session in the office, and that traditional resistance will be eliminated in the interest of redirecting thousands of hours spent documenting services after the fact into increased revenue generating time. • Central scheduling: Working with APGs requires a knowledge of not only which procedures can be offered, but also what procedures will make a difference in the patient’s treatment outcome; in order to make financial ends meet, two billable procedures will need to be scheduled for each client visit • Enterprise billing and QA automation: Most clinics have at least parts of this effort implemented; in your facility is there a chain of data that reduces paperwork and auditing demands? —o Assessment feeds problems to the treatment plan —o Treatment plans designed with “point and click” libraries for problems (coming from assessments automatically), goals and objectives —o Progress Notes related to the treatment plan and a service record that is automatically created for billing so a person doesn’t have to do that later —o Integrated Scheduling for follow-up visits —o Alerts to Central Scheduling to review the upcoming service and assure an appropriate second procedure is scheduled to encourage the best outcomes for the patient
And the list goes on.
The problem, still, is that everybody in your organization is too busy to make sure this happens. In order to implement these survival measures, a professional is the ticket to success. Click on “About Terry McLeod” above for more.
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