NYAPRS Note: As many of us are making New Year’s resolutions this week, it’s valuable to recognize that professional resolutions in the context of health reform are increasingly shared across our system. The challenges and significant pressures to overcome are common to us all. Behavioral health providers may retain strategies for weathering change that are ultimately unhelpful in the new climate, while others push personal and professional boundaries in seeking sustainability. Consider setting professional resolutions this week about how your individual and group process will adapt to meet the busy year ahead.
For Behavioral Health Groups, a Busy 2015
Crain’s Health Pulse; 1/5/2014
The year ahead will be a transformative one for behavioral health providers—but many will struggle to keep pace with the state’s 2015 reform agenda.
In April, barring a delay, New York City adults with behavioral health needs will be enrolled in Medicaid managed care plans. Previously, providers “carved out” behavioral health services, while managed care plans were responsible for medical services. Care will be integrated so that behavioral health and substance abuse services are delivered at the community level, avoiding costly hospital visits.
There is a reason providers are worried about the latest Medicaid reform. When the state introduced Medicaid health homes in 2012, smaller providers grappled with the program’s delayed rollout and compressed implementation time frame.
“My concern for 2015 is that there are just too many initiatives that are rolling through,” said Patricia Goldstein, chief operating officer at the Coalition for Behavioral Health Agencies, an advocate for about 100 New York behavioral health nonprofits. “The providers have policy fatigue.”
The schedule is ambitious indeed. The Fully Integrated Duals Advantage program, or FIDA, took effect Jan. 1. Enrollment in the Developmental Disabilities Individual Support and Care Coordination Organizations will be mandatory in October. At the same time, providers are investing in technology so they can share patient data through SHIN-NY.
In the case of FIDA, the state had not set reimbursement rates as of Dec. 18, and Ms. Goldstein said contracts had not been sent to agencies at that time. “It’s the uncertainty at this point that is incredibly anxiety-provoking and terribly fatiguing.”
The state’s reforms have the potential to improve delivery of care. But preparing for them weighs heavily on nonprofits that lack access to capital, said Donna Colonna, chief executive of Services for the UnderServed, which merged with fellow behavioral health nonprofit Palladia on Dec. 4.
The challenge will be “how do we work with government to support existing nonprofits so that they are there for the transformation effort?” she said. “We have one foot in the future and one foot in the past, so as we’re trying to transform the system, we’re also trying not to destabilize it.”
http://www.crainsnewyork.com/article/20150105/PULSE/141239981