oklahoma ccbhc cost report

Staff Training (CCBHC) (a) In addition to the requirements found in 450:17-21-3, in-service presentations shall be conducted upon hire/contracting and each calendar year thereafter for all CCBHC employees on the following topics: (1) Person/Family-centered, recovery oriented, evidence-based and trauma-informed care; 40, No. You may have missed out on Powerball's $1.08 billion jackpot prize, but there's still $820 million up for grabs with Mega Millions' next draw Tuesday night at 11 p.m. Call COPES (Telephone & Mobile Psychiatric Crisis Services) 918.744.4800. Her e-mail address is: Judith.Dey@hhs.gov. CCBHCs have used a variety of strategies to improve care coordination, including the addition of various provider types to treatment teams and the expansion of targeted care coordination strategies to different populations and service lines. State officials were aware of the limitations of the data available to set rates and expected that the rates would vary from costs during the demonstration, with stabilization over time as more accurate data become available. As shown in Figure 5, most clinics were able to sustain or provide more of these services in the second year of the demonstration. The indented rows are based on a write-in follow-up question regarding specific locations outside of the clinic where CCBHCs offer services. About 1 percent of DY1 costs were payments by CCBHCs to DCOs. Nearly all clinics (97 percent) across all states made changes to their EHRs or HIT systems to meet certification criteria and support quality measure and other reporting for the CCBHC demonstration. This report also describes the experiences of states and CCBHCs reporting the required quality measures in the first demonstration year (DY1). Washington, D.C. 20201, U.S. Department of Health and Human Services, Collaborations, Committees, and Advisory Groups, Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2020, Biomedical Research, Science, & Technology, Long-Term Services & Supports, Long-Term Care, Prescription Drugs & Other Medical Products, Physician-Focused Payment Model Technical Advisory Committee (PTAC), Office of the Secretary Patient-Centered Outcomes Research Trust Fund (OS-PCORTF), Health and Human Services (HHS) Data Council, Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2018, Certified Community Behavioral Health Clinics Demonstration Program: Report to Congress, 2019, Implementation Findings from the National Evaluation of the Certified Community Behavioral Health Clinic Demonstration, Interim Cost and Quality Findings from the National Evaluation of the Certified Community Behavioral Health Clinic Demonstration, Preliminary Cost and Quality Findings from the National Evaluation of the Certified Community Behavioral Health Clinic Demonstration, Fourth CCBHC Program Report to Congress, 2020 (pdf, 994.74 KB), Access to Services and Benefits & Services Integration. As shown in Table 1, six of the eight demonstration states (representing a total of 56 CCBHCs) selected the PPS-1 methodology and two states (representing ten CCBHCs) selected the PPS-2 methodology. PDF The CCBHC Model - National Council for Mental Wellbeing Finally, the PPS financially incentivizes the delivery of high-quality care by rewarding performance on quality measures. In addition to providing the required scope of services, CCBHCs and participating states must be able to collect, track, and report on a wide range of encounter, outcome, cost, and quality data. Having the clinics go through the process of collecting and reporting cost information helped the state identify and address reporting challenges before the first federally mandated cost reports were due. CCBHCs also have continued to provide services in locations outside of the clinic and make broad use of telehealth to extend the reach of CCBHC services. State-reported measures focus on CCBHC consumer characteristics (for example, housing status), screening and treatment of specific conditions, follow-up and readmission, and consumer and family experiences of care. QBP programs. A CCBH is the behavioral health equivalent of an FQHC and as such should have the same standard. PDF Certified Community Behavioral Health Clinics - National Council for Certified Community Behavioral Health Clinics, commonly referred to as CCBHCs, are a new provider type in Medicaid being offered across Oklahoma. Cost Report. Clinics most often added services within the categories of outpatient mental health and/or SUD services, psychiatric rehabilitation services, crisis services, peer support, services for members of the armed forces and veterans, and primary care screening and monitoring (Figure 3). States and CCBHCs had to project the costs and number of visits for these new services based on very limited information or uncertain assumptions. The average daily rate across the 56 clinics in PPS-1 states was $264 (median rate was $252, and ranged from $151 to $667). (2016). This is the third of the five annual reports to Congress. Across states, the amount of QBP funding distributed in DY1 varied, ranging from approximately $500,000 to more than $17,000,000. The denominator is the number of CCBHCs that provided the individual service, which varies by row (that is, the denominator is the N reported in the "Offered service" column in the same row). As shown in Figure 1, and Appendix Table A.1, most CCBHCs already employed licensed clinical social workers (LCSWs), SUD specialists, nurses, a medical director, bachelor's degree-level counselors, case managers, adult psychiatrists, and peer specialists/recovery coaches before they received certification. Collectively, these reports establish a basis for evaluation of the reasonableness of the by the provider's contract with the Oklahoma Health Care Authority (OHCA). According to state officials, the CCBHCs and state agencies were successful in collecting and reporting data on the required quality measures to the HHS Substance Abuse and Mental Health Services Administration (SAMHSA) during DY1. State officials in Pennsylvania instituted a "dry run" of the cost reports, which covered the first six months of the demonstration. Considerations for the Design of Payment Systems and Implementation of Certified Community Behavioral Health Centers. DISCLAIMER: The opinions and views expressed in this report are those of the authors. Although state officials recognized that not all CCBHCs would be fully staffed at the outset of the demonstration, it was important to set the rates under this assumption in order to avoid constraining hiring. Early in the demonstration, CCBHCs generally addressed the challenges to maintaining EBPs and providing the full scope of CCBHC services, although officials continued to explore ways to support clinics' efforts to offer the full range of services. [12] PPS-2 rates tended to be higher in CCBHCs that served a smaller number of clients versus those that served a higher number of clients, as measured by the total visit-months. However, state officials and CCBHC staff reported some challenges to reporting accurate cost information. Pincus. Across all PPS-1 clinics, the average DY1 visit-day cost was $234 and ranged from $132 to $639. This highlights the importance of building-out technological infrastructure for the demonstration to support data collection for mandated quality reporting. During the demonstration, states and CCBHCs have focused on increasing access to care, maintaining the staffing and scope of services requirements in the certification criteria, and ensuring coordinated care for CCBHC clients. In the demonstration's second year, CCBHCs and states built on and further refined efforts to hire and maintain staff, increase access to care, sustain the full scope of CCBHC services, and ensure coordinated care for CCBHC clients. Report shows most hospitals in Oklahoma aren't fully transparent with service costs. Second, states' initial PPS rate calculations may have assumed smaller caseloads, while CCBHCs increased their caseload size through efforts to increase access to care. States were able to choose between two PPS methodologies developed by the HHS Centers for Medicare & Medicaid Services (CMS). Rates could be higher than costs if: (1) clinics overestimated staff costs; or (2) underestimated the number of clients served. While the certification criteria allowed for some services to be provided by DCOs, officials suggested that CCBHCs preferred to provide services directly because they wished to embrace the model fully and were reluctant to assume oversight responsibility for another provider's services. States reported reductions in emergency department and hospital visits among CCBHC clients, leading to cost offsets. A: Experian 1-888-397-3742 Equifax 1-800-685-1111 Transunion 1-800-916-8800 Q: Identity Theft or Fraud, who do I call? . For example, claims and encounter data related to the demonstration may be submitted up to two years after a service has been rendered. [1] To date, this requirement will result in five annual reports to Congress, which are to include the following topics: (i) an assessment of access to community-based mental health services under the Medicaid program in the area or areas of a State targeted by a demonstration program compared to other areas of the State; (ii) an assessment of the quality and scope of services provided by certified community behavioral health clinics compared to community-based mental health services provided in States not participating in a demonstration program under this subsection and in areas of a demonstration State that are not participating in the demonstration program; and (iii) an assessment of the impact of the demonstration programs on the Federal and State costs of a full range of mental health services (including inpatient, emergency and ambulatory services). First, the rates assumed operational costs for fully staffed clinics, while in fact some positions went unfilled due to hiring challenges or staff turnover. The .gov means its official. CCBHC status enables clinics on average to serve more than 900 more people per clinic than prior to CCBHC implementation, or a 23% increase. Ringel, C.K. Ranallo, P.A., A.M. Kilbourne, A.S. Whatley, & H.A. Changes in New Jersey CCBHC population-specific rates from DY1 to DY2 54 TABLE A.9. Current through Vol. Each report shall include assessments of: (1) access to community-based mental health services; (2) the quality and scope of services provided by Certified Community Behavioral Health Clinics (CCBHCs); and (3) the impact of the demonstration programs on the federal and state costs of a full range of mental health services. CCBHC Cost Report Instructions | Guidance Portal - HHS.gov This report summarizes changes in CCBHC rates and costs from demonstration year one (DY1) to DY2, performance on quality measures in DY1, and the extent to which states provided quality bonus payments (QBPs) to CCBHCs for DY1. Average blended rates were calculated by weighting each rate by the number of visit-months in that category in DY1 according to the cost reports and then calculated the average for the clinic. Section 223(a)(2)(C)(iii) outlines coordinated care requirements that include the development of partnerships or formal contracts with community providers including schools, child welfare and criminal justice agencies and facilities. . For example, some states and clinics found that consumers were not availing themselves of certain required EBPs or access requirements as frequently as expected, and modified these practices to better reflect actual patterns of use. Proportion of CCBHCs that Provided Services Outside of Physical Clinic Space in the Past 12 Months, FIGURE 3. There are at least two potential reasons for the tendency of the CCBHC rates to be higher than costs during DY1. NA reflects that CCBHCs did not report this information for the period before CCBHC certification. This is the fourth annual report to Congress describing results from the Certified Community Behavioral Health Clinic (CCBHC) evaluation. In addition, claims analyses will be conducted to answer the questions about the demonstration posed by Congress. These become your anticipated costs. Format developed by CMS. HHS Announces Over $120 Million In Funding Opportunity for Certified Report shows most hospitals in Oklahoma aren't fully transparent with CCBHCs are required to serve anyone who requests care for mental health or substance use, regardless of their ability to pay, place of residence, or age - including developmentally appropriate care for children and youth. However, in March 2018, 1 CCBHC withdrew from the demonstration after Nevada revoked its certification. For instance, some changes in staffing or the composition of care teams may be the result of clinics identifying more efficient and effective ways of providing required CCBHC services. In addition to the six required measures, Minnesota also used the CMS-optional measure Screening for Clinical Depression and Follow-Up Plan in determining QBPs, and New York added two state-specific measures based on state data regarding suicide attempts and deaths from suicide. ET. To ensure the availability of the full scope of CCBHC services, service delivery could involve the participation of Designated Collaborating Organizations (DCOs), which are entities not under the direct supervision of a CCBHC but that are engaged in a formal, contractual relationship with a CCBHC to provide selected services. The state average visit-month cost was $679 in Oklahoma and $793 in New Jersey. 60-Day Tribal Consultation Period:8/24/21 10/23/21. Future evaluation activities will include an impact analysis examining changes in service utilization and costs. Jeff Gritchen/Orange . All demonstration states except Oregon offered bonus payments based on CCBHCs' performance on quality measures. Section 317:30-5-267 - Reimbursement. Direct CCBHC service costs - personnel/other then personnel services. Oklahoma's three CCBHCs reduced the proportion of their clients seen in emergency departments by 18-47% (rates varied by clinic) and those admitted to inpatient care by 20-69% over the first four years of the program, compared to Most CCBHCs and states did not submit quality measure performance data to HHS in time for this report. Oklahoma; Oregon; Pennsylvania; Puerto Rico; Rhode Island; South Carolina; South Dakota; Tennessee; Texas; Utah; Vermont; . PDF Section 223 Demonstration Programs to Improve Community - Medicaid States reported that the most common strategy that CCBHCs used to increase service access was the introduction of open-access scheduling. PDF Illinois Certified Community Behavioral Health Clinic (CCBHC) Cost Download the Guidance Document Final CCBHC criteria[9] require states to report 21 quality measures as part of their participation in the demonstration, including nine clinic-reported measures and 12 state-reported measures. How do I get a copy of my Credit Reports? [2] The next report will discuss further findings on quality measures and costs of the demonstration. Finally the report assesses the costs to CCBHCs for providing the required services, and compares the demonstration payment rates to actual costs.
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