JMOC Update: Behavioral Health Redesign November 16, 2017 - PowerPoint PPT Presentation

JMOC Update: Behavioral Health Redesign November 16, 2017

Background for Today’s Behavioral Health Update Today the Departments will provide an update on the behavioral health testing that occurred between October 25 – November 12, 2017. The information presented today will describe testing that has occurred with Ohio Medicaid and the MyCare Ohio plans, and reflect both general and beta testing results. Success of the beta test is measured by the ability of 50% of participating providers to submit clean claims that are adjudicated properly. 2

= Submitted Beta BH Redesign Beta Test Volunteers as of Nov. 13, 2017 (1) Test Scenarios  Greentree Counseling Center  Cornell Abraxas Group, Inc.  Child & Adolescent Behavioral Health   A Renewed Mind Harbor Behavioral Health  Cornerstone of Recovery  Child Focus   Access Counseling Services Healing Hearts Counseling Center, LLC  Covenant  Child Guidance & Family Solutions   Addiction Services Council Health Recovery Services, Inc.  Cuyahoga MH  Choices Behavioral Health Care   Allwell Behavioral Health Services Hispanic CD Services  Cuyahoga SUD  Christian Children’s Home of Ohio   Alta Behavioral Health Homes for Kids of Ohio Inc.  Darke County Recovery Services  Churchill Counseling Services, Inc.   Alternative Paths, Inc. Hopewell Health Centers, Inc.  Directions for Youth and Families  Clermont Recovery Center   Alvis Huckleberry House, Inc.  Eastway Corporation  Coleman Professional Services   Anazao Community Partners Ikron Corporation  Eden Counseling Centers  Columbiana County Mental Health   AP Liberty Manor CSN Integrated Services for Behavioral  Epilepsy Association Clinic  AP Supervised Living CSN Health  Family and Community Services  Columbus Area Integrated Health   Applewood Jewish Family Service Association  Family Life Counseling and Services, Inc.   Arizona Counseling & Consultation Jewish Family Services Psychiatric Services  Community Assessment and  Services Lake-Geauga Recovery Centers, Inc.  Family Recovery Center Treatment Services   Beech Brook Licking County Alcoholism Prevention  Family Resource Center  Community Behavioral Health Center  Bellefaire Program  Far West Center  Community Counseling Center of   BrightView, LLC Life Solutions South  Firelands Counseling & Recovery Ashtabula   Butler Behavioral Lighthouse Youth Services, Inc. Services  Community Counseling Services, Inc.  Health/Transitional Living Lima UMADAOP  First Step Home  Community Drug Board DBA   Catholic Charities Southwestern Lutheran Social Services of  Focus Residential Group Community Health Center Ohio Northwestern Ohio  Foundations Behavioral Health  Community Mental Healthcare, Inc.   Cedar Ridge Behavioral Health Mahajan Therapeutics Systems, Inc.  Community Support Services, Inc.  Solutions, LLC Mansfield UMADAOP  Friel and Associates  Compass Family & Community   Center for Behavioral Health, Inc. Marion Area Counseling Center  Frontline Service Services   Center for Families and Children Maryhaven  Full Circle to Completion  CompDrug   Central Clinic Matt Talbot for Recovering Men  Greater Cincinnati Behavioral  Comprehensive Psychiatry Group, Inc.   Century Health Matt Talbot for Women Health Services  Concord Counseling Services 3

= Submitted Beta BH Redesign Beta Test Volunteers as of Nov. 13, 2017 (2) Test Scenarios  Matt Talbot Inn   Oriana House, Inc. Signature Health, Inc.   The Crossroads Center Maumee Valley Guidance Center   Passage, Inc. DBA Deaf Think Positive, Sojourner Recovery Services   The Lighthouse, Inc. Mental Health Services for Clark  Inc. Solutions Community Counseling  The Main Place, Inc. County Inc.  Pathways Counseling Center, Inc. and Recovery Centers   The Nord Center Meridian HealthCare   Perry Behavioral Health Choices, Inc. SORC, LLC   The Recovery Center Mid Ohio Psychological Service   Phoenix Rising Behavioral Healthcare Southeast, Inc.   Townhall II Midtown  & Recovery Southeastern Ohio Counseling   Travco Behavioral Health, Inc. Murtis Taylor Human Services  Portage Path Behavioral Health Center LLC  Tri County Help Center, Inc. System   Primary Care Solutions Spectrum Outreach Services, LTD   Twin Valley Behavioral Health Muskingum Behavioral Health   Project Cure, Inc. St Aloysius Orphanage  Center National Youth Advocate Program   Project Woman St. Joseph Orphanage   UMADAOP Dayton NBH Cuyahoga   PsyCare Stella Maris, Inc.   Unison Behavioral Health Group NBH Lake   Rakesh Ranjan, MD & Associates, Inc. Summit Psychological Associates,   University of Toledo Medical NBH Mahoning  Reach Counseling Services Inc.  Center Necco LLC   Recovery Resources Sunrise Treatment Center   Urban Minority Alcoholism & Neil Kennedy Recovery Center/Yo   Recovery Services of Northwest Ohio, Talbert House Drug Outreach Program of Comm on Alcoholism  Inc. Talbot Clinical Services  Cincinnati, Inc. New Albany Home Health Solutions   Rescue, Inc. TASC of Northwest Ohio   Village Network New Concepts   Resident Home Corporation, DBA TCN Behavioral Health Services   WellSpring New Horizons Mental Health  Envision The Bair Foundation  WomenSafe, Inc. Services   RFS Charitable Foundation The Buckeye Ranch   Wood County Children’s Services North Central Mental Health   Salvation Army The Center for Child and Family Association Services  Samaritan Behavioral Health, Inc. Advocacy, Inc.   Woodland Centers, Inc. Northeast Ohio Behavioral Health   Scioto Paint Valley Mental Health The Counseling Center of Wayne &   Worthington Center Northeast Ohio Health Services Center Holmes Counties  Management Co., Inc. Oesterlen Services For Youth, Inc.   Sequel Pomegranate Health Systems The Counseling Source, Inc.   Youth Advocate Services OhioGuidestone   Shaker Clinic The Crisis Intervention and   Zepf OneEighty, Inc.  Shawnee Mental Health Center, Inc. Recovery Center, Inc. 4

Ohio’s Behavioral Health Population 96% of Ohio Medicaid’s behavioral health population receives services on a fee-for-service basis. The remaining 4% are served by MyCare Ohio plans and reside in one of the 29 MyCare Ohio demonstration counties. Individuals Served by Ohio Medicaid Who Received BH Services in SFY17 MyCare BH 18,777 Recipients Non-MyCare 422,188 BH Recipients MyCare Ohio 0 100,000 200,000 300,000 400,000 500,000 Demonstration Regions Source: ODM QDSS, November 2017 5

Overall Testing Summary As of November 12 th , 63 agencies have submitted test claims via FFS and 14 agencies have submitted test claims to the MyCare Ohio plans. Agencies Testing with FFS or MyCare Total Test Claims Submitted for FFS and MyCare Small Medium Large FFS 14 18 31 MyCare Claims 234 Submitted MyCare* 2 7 5 FFS Claims 5,007 Submitted Agency Size Key: Small = <500 clients Medium = 500 – 2,000 clients 0 1,000 2,000 3,000 4,000 5,000 6,000 Large = >2,000 clients Source: DXC and MyCare testing reports 6

MyCare Ohio Plan Network Adequacy The MyCare Ohio plans have met network adequacy requirements in all 29 MyCare counties. Minimum MH and Number of MH and Meets Network MyCare Ohio Plan SUD Provider SUD Provider Adequacy Locations Required Locations Contracted Requirements? MH: 56 MH: 96 Aetna SUD: 22 SUD: 90 MH: 65 MH: 175 Molina SUD: 22 SUD: 114 MH: 79 MH: 145 CareSource SUD: 22 SUD: 68 MH: 79 MH: 92 United Healthcare SUD: 22 SUD: 48 MH: 79 MH: 211 Buckeye Health Plan SUD: 20 SUD: 57 Map depicts counties where all MyCare Ohio Plans have met network adequacy requirements. Colors represent the MyCare regions. 7

Fee-For-Service Beta Testing Results ODM and OhioMHAS are actively monitoring beta testing progress. Beta Testing Process The Departments have designed specific scenarios that providers must use to participate in the beta test • Scenarios have been designed to test situations applicable to both mental health and substance use • providers Beta providers must test with both ODM and the MyCare Ohio plans that they are contracted with (if • applicable) While State-defined scenarios must be used for beta testing, providers are encouraged to submit additional • test claims for any scenarios that could be applicable to their business FFS Beta Test Results Beta Test Volunteers: 179 Agencies that have tested with FFS: 63 Total beta scenarios submitted: 227 Agencies that have submitted beta scenarios: 24 (26 unique scenarios tested of the 60 State-recommended scenarios) Percent of beta scenarios adjudicated properly: 98% 8