Jonathan's Journal 12-06-15


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Jonathan's Journal
Jonathan
Signature Health, Inc. Newsletter
In This Issue
BH Redesign
Holidays and EOY
Thought For The Week
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Issue: # 28

December 6th, 2015

BH Redesign is like ICD-10
I dont want to be the Grinch who stole Christmas but this iscritical to the future of Signature Health and all Mental Health Agencies in Ohio...

Many of you may not realize that there has been significant work done by the Ohio Department of Medicaid to redesign the Medicaid funding and payment system for community mental health/addiction centers (CMHCs).  I have been honored to be one of 50 stakeholders asked to provide feedback to the State Department on their change efforts. Unfortunately our advocacy has not yeilded much change in the Department's approach.  In short they are changing the coding system and the payment structure that we have used for decades to one that is compliant with HIPAA and the National Correct Coding Iniative.  

These changes are not a simple change from one code to the other.  We are changing from time based coding/payment to procedure based coding/payment.  In many respects its like the switch from ICD-9 (International Classification of Diseases) to ICD-10 where one ICD-9 diagnostic code could now have dozens of possible equivalent codes in ICD-10.  Similarly one service code may now have several possible equivalent codes that depend upon complexity of the patient, credentials of the person providing the service, and fidelity to evidence based best practices, and other factors.

Follow The Money... The issues causing significant concern for CMHCs like Signature Health is the proposed payments for the new code set appear to be 20%-30% lower than current payments across the board.  These lower payment rates are to help finance an expansion of covered services such as drug and alocohol residential services, Assertive Community Treatment (ACT), and Intensive Home Based Treatment (IHBT) among others.

Most CMHCs have 70% or more of their business with Medicaid.  So the redesigned system with 20-30% rate cuts, if enacted as proposed, will require SIGNIFICANT business model changes or CMHCs won't survive. 

I feel fortunate that Signature Health has long ago begun to change our business practices in anticipation of these changes so that we are positioned to not only survive but to thrive in these turbulent times!  To further position ourselves, In 2016 we will expand our quality improvement program by integrating a Healthcare 6 Sigma continuous process improvement system.  Stay tuned for more announcements about the Healthcare 6 Sigma Process Improvement System.
Holidays and Employee of the Year
 
To all of our staff, collegues, and community partners of the Jewish faith I would like to wish you and your families a very Happy Hannukah!

 

Attention Last Minute Shoppers !  Only 18 Shopping days left till Christmas!  


Please join us for our Annual Holiday Party to be held on Wednesday December 9th at 6:30 pm at the Croatian Lodge.  

Please bring your spouse/partners/significant others AND your children !

PLEASE RSVP to Paul Brickman especially with a count of children and their ages so we can plan accordingly.

EOY -  I will now begin taking nominations for Employees of the Yearawards.  If you not familiar, each year we recognize our fellow staff in the 6 Agency Values areas 
Teamwork
Integrity
Community
Excellence
Innovation
Service

Holiday Bell

Most nominations come from the staff members, but we welcome nominations from former staff and all other readers of my Journal.  So this truly is an honor bestowed by peers and colleagues.  You can nominate as many people as you like for as many categories as you like.  I just ask that for each person and each category you write why you are making the nomination.  So if you want to nominate someone for 3 values please write 3 separate nominations outlining why that person deserves to be honored.  Send nominations to me directly at jlee@signatureheatlhinc.com with EOY as the subject of your email.
Thought For The Week

The greatest discovery of my age is that people can change their circumstances by changing the attitude of their mind. -William James

Make it a Great Week !  

Jonathan

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