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IDD and Managed Care – How Do You Prepare?

As “Captain Obvious” has said, “There seems to be some changes coming our way”.  The problem that the Captain has ignored is we aren’t really sure what those changes will be and how they will affect our agencies and clients.

It’s been said that the potential for change in our market is there, but until contracts are signed, you really don’t know how to prepare.

With that being said, the truth is you do need to prepare.  If you don’t, you’ll find yourself falling behind in an already competitive marketplace.

When you cut through all the noise, common sense can help guide your preparation.

Invest in technology infrastructure – The move to managed care has put increasing pressure on provider organization to collect, manage, share, and analyze data for population health management and value-based contracts.  The expectation for provider organizations to offer consumer portals and monitor staff improvements will also come into play. 

As an example, the medical/hospital world has moved to this model.  It’s only logical that I/DD and Mental Health follow suit.

Technology is not just an EHR data repository.  The idea of integrating your entire agency’s back office functionality with your clinical data is the model hospitals have been using successfully for years.

Adjust revenue cycle management practice – Provider organizations must be able to provide detailed documentation of services provided, as well as accurate claims. The old fee-for-service (FFS) billing skills are of no use in a managed care environment. Preparing may mean training, it may mean outsourcing, or it may mean completely replacing your current system and staff.

The challenges to a transition to managed care are especially focused on claims and billing processing.  An integrated platform can alleviate those challenges.

Adjust organizational culture – You should realize that jobs and responsibilities within the organization may be altered or changed dramatically. Leadership should be prepared for these changes and a focused approached to staff education and preparation for change will be key to your continued success.

Invest in the future – The specifics of the future may be murky right now.  However by making the investment of preparation, your agency will be ready to prosper in the “new normal” rather than trying to catch those that have.

All EHRs are not the same — The need for an IDD specific platform

We know the Intellectually Developmentally Disabled and Mental Health space is unique. Agencies providing incredible care and nurturing support for clients is what sets the IDD/MH space apart from other aspects of healthcare.

Yet with all the advances in electronic health records (EHR), we in the IDD/MH space continue to struggle with utilization of EHRs that were designed for other specialties in mind.

A University of Arizona study indicated that the use of an IDD specific EHR template provides a greater level of comfort in residents providing care to IDD patients. It stated that all residents who took part in the study “Strongly Agree” that an IDD specific EHR template increased their knowledge and made them more comfortable to facilitate information and provide quality care to their IDD patients. The collection of important health and social indicators through the EHR improved the clinical interaction with those patients.

What does this mean to an IDD/MH agency?

Simple, all EHRs are not the same. An EHR or Agency Management Platform designed specifically for IDD/MH will collect the unique data of IDD/MH most effectively. The management of clinical outcomes, client centered programs, streamlined operations and improved financial status are a few of the aspects an IDD/MH specific platform can provide to an agency.

So whether you are upgrading your EHR or taking the EHR plunge for the first time, ask your vendor if their platform is designed specifically for your world.

NC HealthConnex

Charlotte, NC – March 14th, 2018 – Aymira Healthcare Technologies, LLC, a leading provider of BH/IDD clinical software throughout North Carolina and other states, is proud to announce the certification of connectivity for the transfer of Continuity of Care data to NC HealthConnex, the state-designated health information exchange. The achievement represents a milestone reached through a collaborative effort between the North Carolina Health Information Exchange Authority (NC HIEA) in Raleigh and their technical vendor, SAS Institute Inc. in Cary, and Aymira Healthcare Technologies, LLC in Charlotte, NC.

NC HealthConnex is a tool to link disparate systems and networks for a more holistic view of the electronic patient record. With this development, the Aymira Healthcare Technologies EHR OnTarget is capable of securely transferring Continuity of Care data to NC HealthConnex including client demographics, encounters, problems, medications, allergies, social history and order results.

“This is a major milestone for us, and we couldn’t be happier about working directly with the NC HIEA and their technical partner SAS to deliver on this initiative,” said Joe Speidel, CIO at Aymira Healthcare Technologies. “We are especially pleased that, through the hard work of all three parties, we can now deliver an option for connectivity to any behavioral health provider agency in North Carolina.”

State law currently requires that any health care provider who receives state funds for the provision of health care services (e.g. Medicaid, Health Choice, State Health Plan, etc.) connect by various dates within the next two years. The NC HIEA has issued a letter of invitation to all providers using OnTarget indicating that they can utilize OnTarget to connect in order to meet the state mandate.

To date Aymira Healthcare Technologies has worked with twelve provider agencies to build a connection, and is currently working with over thirty more to sign the NC HIEA Participation Agreement and begin the connection process. Any provider not in the queue may sign a Participation Agreement to initiate the certification process.

The three groups are continuing the development effort toward the next phase of the project, bi-directional integration, which will allow clinical data to be viewed in the OnTarget software and further facilitate the secure exchange and integration of patient data. Each group’s team lead has acknowledged looking forward to continuing the collaborative effort to maximize the feature set available to behavioral health/IDD providers in North Carolina.

Your EHR: Cost Center or Revenue Center?

Your EHR: Cost Center or Revenue Center?

What is the first thing that comes to mind when you think “Electronic Health Record”?

Some comments may not be family friendly.

More than likely, the last thing that comes to mind concerning your EHR is how much revenue it has generated for your agency this month.

However, with an Advanced Agency Management Platform such as OnTarget, that is exactly what you will be realizing.

If history within healthcare can teach us anything, then the experience of physical health organizations is one that we in the Intellectually Developmentally Disabled and Mental Health fields can learn from their experiences.

For example, hospitals have been facing decreasing reimbursement and increasing expenses for decades.  Sounds very familiar to IDD/MH.  Their profit margins and cash flow have been notoriously slim with many organizations closing.  Again, similarities to IDD/MH.

When hospitals implemented EMR systems, it was usually by stick rather than a carrot that moved them forward.

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NC Fast 40

Fast-Growing Middle-Market Companies Make Top 40 List

Aymira Healthcare Technologies parent company Caretech Management was recently rated as the 4th fastest growing Mid-Market company in North Carolina.  Thank you to our clients who are the reason for this recognition.

October 10, 2018

PINEHURST – Forty North Carolina companies were honored on Wednesday, October 10, at Pinehurst Resort for being named to the 2018 N.C. Mid-Market Fast 40 list. Created by accounting firm Cherry Bekaert LLP and Business North Carolina magazine, the list ranks midsize companies based on revenue and employment growth.

In addition to Business North Carolina and Cherry Bekaert, supporting sponsors included Raleigh­based law firm Manning Fulton and Birmingham, AL-based Regions Bank. Companies who made the list were recognized at a luncheon, which included an awards presentation and a video of a roundtable discussion sponsored by Lynchburg, VA-based Scott Insurance with representatives from some of the winning companies. The list, coverage of the roundtable, and company profiles will be published in a supplement to the November issue of Business North Carolina magazine.

For more than 70 years, Cherry Bekaert LLP has been helping clients take their businesses as far as they want to go. As one of the largest national public accounting firms headquartered in Richmond, Va., Cherry Bekaert’s resource network stretches across the Southeast: Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia and Washington, D.C. It also extends nationally and internationally through an alliance with Baker Tilly International, an association of independent accounting services and consulting firms. For more information, visit www.cbh.com or contact August P. Keller Ill, chief marketing and sales officer at 800-849-8281.

Business North Carolina magazine has explored what’s happening in one very special place – North Carolina – for more than 37 years, producing quality, in-depth journalism that digs into the stories behind the news. In addition to the monthly magazine, BNC publishes its annual North Carolina Economic Development Guide and partners on projects with various statewide organizations. For more information, visit BusinessNC.com or contact Ben Kinney, publisher, at 704-927-6273.

IDD/MH 2018 Trends that will continue through 2019

IDD/MH 2018 Trends that will continue through 2019

IDD and Behavioral health providers want to improve their connection to the healthcare system overall.  However, that may bring new issues and challenges to achieve.

We’ve seen trends develop throughout 2018 with varying degrees of impact.  More than likely the intensity and cadence of these trends will heighten throughout 2019.

 

Consolidation

Mergers and acquisitions are expected to continue in the fragmented behavioral health landscape. Private equity firms with platform deals will seek to build out their portfolios more strategically in 2019, looking for smaller targets with potentially lower multiples that will fill service gaps in the continuum of care.

But for-profit isn’t the only sector seeing activity. Given the increasing pressure on Medicaid reimbursement, non-profit organizations are looking to merge or possibly be absorbed.

The need for agency fiscal sustainability is more important than ever.

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Denialselectronic health record idd mh

Don’t Deny Your Denials

An easy trap for many agencies is to ignore the actual amount and length of their denials.  Typically, our industry experiences a 15-25% denial rate.  Many agencies budget at a 20% rate.

For a medium sized agency, that can equate to over $145,000 a month in denials and delays.

What could your agency do with an additional $100,000 per month?

In the continuing battle to reduce denials, most of the errors lie in the human factor.

We all know there are times when we cannot read the client’s handwriting on their intake paperwork or on the doctor’s notes. Typos and missing information continue to be a plague.

A denied claim slows the reimbursement process and hampers the financial sustainability of your agency.

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Total Cost of EHR Ownership

Total Cost of EHR Ownership – The Power of an Integrated Platform

Organizations that wish to improve on their success must take EHR Total Cost of Ownership (TCO) into consideration.

The behavioral healthcare business model is particularly complicated—with ripple effects between providers, payers, technology, and regulation that affect the organization’s bottom line—making TCO difficult to quantify.

The majority of the indirect costs that factor into TCO appear to have one common denominator: legacy software.

Incumbent business solutions lack the adaptability to keep pace with the dynamic business model of behavioral health care, and organizations are having to fill functionality gaps with supplemental training or workarounds, whether additional costs in maintenance or customized releases and, most importantly, forego fleeting opportunities for supplemental revenue.

The good news is several of these aspects of TCO can be mitigated, if not eliminated outright. Modern platform technology enables agencies to rapidly configure workflows, allowing the creation of a robust, yet simplified user experience, while affording the adaptability to stay ahead of changing healthcare regulation.

When it comes to TCO, the devil is in the details. Organizations that wish to bring their TCO down to a manageable level will need to take control of the indirect costs inherent in legacy software by leveraging platform technology.

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