ACHESS: Using Smartphones to Prevent Relapse

Arapahoe House, a substance abuse treatment facility in Aurora, Colorado is one of several organizations around the country implementing ACHESS, a relapse prevention smartphone app. The app, created at the Center for Health Enhancement Systems Studies, of which NIATx is a part, offers support, information and other resources to patients leaving residential care.

This article from the Denver Post highlights the use of ACHESS at Arapahoe House.

Currently, agencies that are members of the CHESS Health Education Consortium have access to ACHESS. Click here for more information on ACHESS or the CHESS Health Education Consortium.

Spark change in your organization: Think weird

Sometimes even innovative organizations hit a change plateau.

Read about some "weird but proven ways" to kick start change and challenge attitudes in your organization.

Weird Ideas That Spark Innovation.

And watch this TED talk for ideas on how to make your PowerPoint presentations really come alive:

http://www.ted.com/talks/lang/en/john_bohannon_dance_vs_powerpoint_a_modest_proposal.html

Don Berwick: Possibility for change has never been greater

Don Berwick, former administrator for the Centers for Medicare & Medicaid Services, spoke at this year's Institute for Healthcare Improvement's National Forum. He shared his thoughts on the future of health care and health care reform. You can read a summary of his comments at boston.com.

You can also listen to an interview with Don on Boston NPR.

The hand-off: A hands-on approach to client transfers

One area in the treatment continuum that often proves to be problematic is the system by which a client is transferred between levels of care: the “handoff”. Any number of things that may go wrong during the handoff can be disruptive to the client's treatment and can contribute to dropouts. In this sense, the handoff process is part of the NIATx aim of increasing continuation.

What happens when a person first calls your agency for help? Does a live person answer the phone, or is the caller directed through an endless cycle of automated prompts? The caller might talk first to a receptionist, who then might hand off the call to somebody else, who then might invite the caller to leave a voicemail message. How many different people does a client meet with during a first intake appointment? How many forms does the client have to complete during the appointment - forms that request the same information multiple times? Every transition from one level of care to the next in addiction treatment is a handoff that presents a potential interruption or even an end to the client's recovery journey.

Think about a system outside the treatment field where handoffs are smooth and efficient. Maybe it's the pit crew of a champion in a NASCAR race or the passing of a baton between Olympic relay racers. What makes them so good? How can you learn what makes them so good and use those ideas in client care transitions?

NIATx has several resources to help you with handoffs. Check out the Increasing Continuation Between Levels of Care promising practices on the NIATx web site. And make sure to read the article “Don’t Fumble the Treatment Handoff” in Addiction Professional magazine.

The Aha!s of Change: What we can learn from the McRib

I find it difficult to clearly explain why it is so important to go outside the field for ideas on how to improve and how to get those ideas. So I am going to try again. One of these days I will get it right.

A lot of people are becoming pretty good at understanding the needs of their customers. The walk-throughs are being used pretty extensively as well as nominal group and focus group meetings. It is exciting to see that happening. And of course it is natural to say: "Well, now that we understand the problem, let's solve it.” I love rapid- cycle improvement!

But there is a risk that we will jump to an obvious solution. The obvious solutions are very likely to have been tried in SUD before. And they may have worked, or they may have worked a little, or worked a lot for a while and then stopped working. So it probably does not hurt to take a one-hour detour to cast a wider net for solutions. Where do we find those solutions? From concepts and problem-solving efforts of people who are tackling a similar problem but in a different industry.

Suppose we were trying to find a way to get people to keep coming back for treatment. What other industries worry about getting people to come back on a regular basis? Lets think out of the box for a second. Well, there is television. They try to get us to come back to their shows. And there are fast food restaurants. Of course there are many others. But let's go with those two for a minute.

We have found the industries. Now we need to find the best of the best in those industries. In many cases they will be obvious. In fast foods, it is probably McDonalds. They must invest enormous amounts of effort in getting people to return. How do they do it? One of us knew the head of marketing for McDonalds, but you could just as easily google. For instance, I googled "How does McDonalds get people to return?" I found millions of responses because many people have studied McDonalds. One thing that comes up over and over again in the few summaries I read was that they segment their customers and find out what those people respond to. Then they target those things people respond to.

The first article pointed out the McRib. Its nutrition is terrible and a lot of people hate it. But a big segment (typically young guys) of their customers really like it. So what? Well, McDonalds thinks about what would bring those people back. They hit TV programs with a young guy who is going on his honeymoon and he gets a text from a friend saying McRibs are back. For a few seconds he debates whether he wants to go on his honeymoon with this wife watching, perplexed.

What can that story tell us about how to keep our patients coming back? McDonalds would say that one size does not fit all. In our field some may respond to threats, others to reminders, others rewards, etc. But rarely do the same things work for everyone. What if we began to create a database of what our customers respond to? Try some things, see what happens, and then put those results into the database, so we know what to try (or not try) to get each person back.

How long would it take to: 1) Identify other industries that deal with a problem similar to ours? 2) Identify one of the best organizations at solving that problem in that industry? 3) Ask Google Scholar to identify what makes McDonalds (or whatever) so good. 4) Read at least the abstract of a couple of articles. 5) Ask, “What is it that they do that could be helpful for us?”

I would say one hour, two at most. I think it’s worth it.

More info, fewer clicks: the NIATx website update

The NIATx principle “understand and involve the customer” has helped guide the latest redesign of our website. What have we heard from our website customers? Frequently, we hear that www.niatx.net has tons of great resources—but they’re sometimes hard to locate. With that in mind, we’ve made a few changes to help you find what you’re looking for in just a click or two.

First, take a look at the home page. Mouse over any of the choices on the blue menu bar and see what pops up—a new menu that gives you a bigger, brighter picture of what’s behind each tab. Check out the reorganized Resource Center content. We revised the headings to guide you more quickly to some of our most popular content.

The NIATx story database, another feature on our website, now contains over 800 entries from organizations across the country. This is the place to go for inspiration, ideas, or tips on how to implement a particular promising practice! We’ve improved the search and sort features so you can more quickly find the stories that will help you the most.

Be sure to visit the NIATx Health Reform Resources page. It contains information and resources that participants in our recent health reform collaboratives have added. Along with a cleaner design, you’ll find a feature that allows you to filter results by project source, category and keyword.

We hope these changes help you navigate the site easier. Let us know how it’s working for you by emailing webmaster@niatx.net.

The Aha!s of Change: What I've Learned Over 50 Years In Organizational Change

Someone recently asked me the key things I have learned over nearly 50 years of working and studying organizational change. At my age, I am surprised that I remember. And in fact I bet I have forgotten many important things and elevated others that don't deserve to be. Furthermore, in thinking about the answers to the question I have come across some contradictions that confuse me.

I am starting this series because I would love to hear what you have learned and how it fits or competes with these. So I hope you jump in and question, argue, and tell me where I am full of it. Lets start today with one of them. Change teams.

A lot of folks think the change team is a key to success. It probably is but the literature and my experience suggests there are teams and then there are teams. What I have learned is that if everyone is in charge, no one is in charge. Andre Delbecq (one of my heroes) studied innovation in Silicon Valley. He found that teams of the really successful companies do it this way:

First, a team leader is chosen and this person is influential and respected. But interestingly, that team leader is personally responsible to make this project be successful and he or she is given the personal autonomy and resources to make it happen.

Second, the team leader is given the authority to pick the team members with the restriction that they, like the leader, must be passionate about the project. The team’s job is to help the team leader accomplish the goals. In several ways this is very different from typical views of teams where the team is the key instead of the leader and where the team has a central role in decision-making.

Third, the team is not held responsible for the success of the effort. So the organization is on the line (by giving resources and authority) and so is the leader. I think it makes for a very different dynamic.

Now for the contradiction. I also really believe it is important to engage the skeptics, but that is not mentioned a lot in what I have read about Silicon Valley. How can only the passionate advocates be on a team? Where do you get the reality testing? To some extent these issues are addressed in other ways that I will talk about later. So rip me apart. I love the pain.

Budget Cut Survival Skills

Maureen Fitzgerald, NIATx editor, gave me a copy of the last issue of Alcoholism and Drug Abuse Weekly with a note saying “Why don’t you blog about this?”. It was attached to an article on Washington state’s budget proposal to eliminate adult substance abuse treatment funding. My first thought was, “Why would I want to write about more depressing state budget news? Everyone knows about that already.” But as I gave it more thought over the weekend, I decided maybe she was right.

First, Washington is not the first state to propose drastic cuts. Almost every state is facing similar problems and proposing similarly draconian solutions. Providers in Illinois, Maine, and other states have fought off huge cuts in addiction treatment budgets through advocacy and finding other places in state government administrative costs that made more sense to cut. So the first thing to do is know your state budget and get to know your legislative representatives and make sure they know and appreciate you. Good advocacy is your first line of defense.

An equally important second line of defense is preparing for reduced government funding by diversifying revenue streams. Any business that is reliant on a single customer is vulnerable, whether that customer is government or General Motors. Over 70% of people who need treatment have insurance. They either are not seeking treatment or not seeking treatment from you. Many businesses are self-insured. If you can demonstrate positive outcomes and get their employees back to productive employment, they will use you over and over again. These are the obvious sources of new revenue. What are some less obvious sources that you have found?

Another important thing to do is to streamline and automate to reduce costs. This is what NIATx teaches. Maybe you have done a few changes to reduce wait times or increase retention. If you have only partially adopted process improvement or only done a few projects, it’s time to dig in and look at every process at your organization and ask “How can we simplify? Is it possible to automate this and how cheaply can we do that?”

It's hard to think about the second line of defense when you are freaking out about the first. But you can't neglect potential revenue streams or cost reduction if you are going to ride this wave of change in the funding environment. NIATx has developed some resources to help you in these tough budget times, including the NIATx Third-party Billing Guide and new Promising Practices related to increasing reimbursement.

Let us know the creative ways that you have managed funding transitions. I know there is a lot we are missing sitting here in our ivory tower and it would be great if those of you who have been managing budget cuts since 2007 had some words of wisdom for the folks in Washington and other states who may be experiencing their first year of panic.

Data Is Your Friend!

When you're conducting a change project, it's easy to get swept up in the excitement of developing and testing different changes. It's crucial to remember that what you are ultimately seeking is a new process that will not only be a change from the old way of doing things, but an improvement on it.

Through data collection and analysis you can determine whether the change you are testing is actually an improvement, or if it's just a different way to get the same unsatisfactory outcome.

Collecting data may sound like a complex process, but we've developed some resources to help. The How to Collect Data page on the NIATx website is a great resource that includes a step-by-step guide to data collection. And the NIATx Tracking and Measuring Tools provide a set of data collection forms and spreadsheets that help you track, evaluate, and graph your data.

Ready, Aim, Improve

If you plunge into a change project without first defining your aim, you and your team are likely to flounder. It's like setting out on a road trip with no clear idea of your final destination. If you have only a vague notion of where you want to end up, you can waste a lot of time and a lot of gas and may decide to just turn around and go home.

A good aim statement keeps you focused on the process you want to improve. It's something you can return to throughout your project, especially when you and your team find yourselves drifting away from your targeted aim.

A good aim statement is specific. It should answer two questions: What are we trying to accomplish? And how will we know if the change is an improvement?

Here's an example: Reduce no-shows to assessment appointments by 50% from an average no-show rate of 80% to 40% by February 1, 2012.

Remember, the aim statement guides your entire change project.

How has a good aim statement helped you and your teams make progress toward your targeted aim?

Check out the Top Ten List for aim statements from the MD Anderson Cancer Center at the University of Texas: http://www3.mdanderson.org/streams/FullVideoPlayer.cfm?xml=perfImp%2Fconfig%2Fcs138_CFG

Using the walk-through in nursing homes

NIATx is participating in a collaborative research program to help older people live independently and stay in their homes.

Named the Active Aging Research Center, this program is funded through a grant from the federal Agency for Healthcare Research and Quality (AHRQ), whose mission is to improve health care for all Americans.

Key NIATx tools like the walk-through will play an important role in this program. I found the following 2-minute video an interesting example of how one man is using the walk-through to help him design better nursing homes.

http://www.wmtw.com/video/29191411/detail.html

Rapid-Cycle Testing and PDSA Cycles: Not the Same Thing

What does "rapid-cycle testing" mean to you? One of the five NIATx principles, rapid-cycle testing gives change teams a way to try out change ideas to see how they work.

I was at a wrap up session of a learning collaborative last week and one of the participants said, "We did PDSA but we didn't do rapid cycle and I think that was our problem". I think she was right. They did their change projects using a Plan-Do-Study-Act method, but they selected changes that took a long time to complete and measure and did not break them down into "small bites" (her own words).

Have you taken too big a bite in a PDSA Cycle only to find that you weren't doing rapid-cycle change at all? How did you regroup? Coaches, what do you do to help people make sure they are making their change cycles small enough to be done in a rapid-cycle way?

Medicine 2.0: technology transforming health care delivery

Last week I attended the Fourth World Congress on Social Media and Web 2.0 in Health, Medicine and Biomedical Sciences, also known as Medicine 2.0. This conference, held at the Stanford University School of Medicine, brought together some of the world's leading experts in using social media and mobile applications to create new ways of delivering health.

How can we use the Internet and social media to improve health as well as patient-caregiver relationships? I came away with loads of ideas to try out with mobile applications like A-CHESS that NIATx is developing.

One recurring theme throughout the conference was how much patients, no matter what their health condition, benefit from networking with others. Social media tools like Facebook and Twitter have become new tools for building the social support patients need. Some other new applications that you'll be hearing about include Google + and www.patientslikeme.com.

This innovative conference also introduced me to some new technologies that transformed my conference experience. We hope to give you a sample of the same at the 2012 NIATx Summit/SAAS National Conference - next year, your Summit conference badge might also be the conference program!

It is becoming increasingly evident that our prediction is true: wireless devices (smart phones, tablets and sensors) will play a critical, even revolutionary role in health care in the future. We look forward to working with you to collaboratively set the future for our field by embracing these technologies.

Recovery Month 2011: No one should have to suffer twice

September, National Recovery Month, (http://www.recoverymonth.gov/) celebrates people in recovery and the treatment providers and support groups that help them.

For NIATx, Recovery Month underscores our mission to help treatment providers remove barriers to treatment and recovery. Recovery Month reinforces our belief that no one should have to suffer twice: first from a chronic disease such as addiction, and again by not having access to appropriate treatment.

One of our newest projects is developing a smartphone application to help people maintain recovery. Click here to watch a video about this project.

Emergency Preparedness - Do you have a plan?

Millions of Americans throughout the northeastern United States were left in the dark and flooded in the aftermath of Hurricane Irene. Lynn Madden, CEO, APT in New Haven CT had a disaster plan ready to roll out. Now that the lights are back on, customers have moved back into permanent facilities and the server is up and running; Lynn and her team are meeting to discuss their observations and make improvements to their plan.

How did the storm affect you? Do you have an emergency preparedness plan? Are you making process improvements post disaster?

Share your tips for mitigating disaster.

Disaster recovery resources from inside and outside the field:

• SAMHSA Emergency Preparedness Plan
• www.ready.gov

New and improved: The NIATx Third-party Billing Guide, Second Edition

Just off the press, the NIATx Third-party Billing Guide, Second Edition, includes an expanded section on coding, more information on utilization review, and case studies and tips from organizations that are creating, improving, or maximizing their third-party billing system.

Download your free copy today!

Free webinars from the Business Operations for Behavioral Health Collaborative

Don't forget to join us for this webinar series hosted by the Business Operations for Behavioral Health Collaborative (which NIATx is a part of).
It's a great opportunity to learn how to implement efficient and cost-effective business solutions at your agency.

And they're free.

The webinars cover 4 main topics:

1. Health Information Technology
2. Billing Operations
3. Compliance
4. Patient Eligibility/Access

Following is information on the next few webinars, including login information. To see the complete schedule visit the NIATx web site.

HIT: Due Diligence when Selecting an EHR or other HIT
7/14/2011, 1:00 PM - 2:00 PM
www.mymeetings.com/nc/join/
Conference number: PW6109579
Audience passcode: 5350462

The Vendor Selection and Due Diligence Process: Electronic Health Record (EHR) acquisition requires a stringent due diligence plan - hear from successful Health Information Technology organizations about what to expect during the selection and contract negotiation process, and gain insights from lessons learned through successful EHR acquisition, adoption, and implementation.

HIT: EHR Workflow Redesign
7/21/2011, 1:00 PM - 2:00 PM
www.mymeetings.com/nc/join/
Conference number: PW6109582
Audience passcode: 5350462

Workflow redesign is essential when implementing an Electronic Health Record. Processes change from the front desk check-in, to the point af care and ultimately to the actual billing process. In this session, we will review actual workflow redesign examples that may assist you in your EHR Implementation.

HIT: EHR Implementation
8/11/2011, 1:00 PM - 2:00 PM
www.mymeetings.com/nc/join/
Conference number: PW6109582
Audience passcode: 5350462

Implementing and EHR may very well be the single largest project you will ever be a part of in your career. There are some important principles to be successful and well defined pitfalls to avoid. You have an opportunity to learn from those who have gone before you- to leverage what worked and what didn't. As you bring your practice into the 21st century with Health Information Technology, it's critical you are as well informed as is possible so that you are one of the organizations that experiences resounding success. This brief presentation will cover the most salient points so that you can help your organization make the EHR leap.

Computer-based registries, Integration and FQHCs

I bet you're all way ahead of me on this. But recently I have begun to realize the essential role computer-based registries will play in the integration of behavioral healthcare and primary care. As you know, the Federally Qualified Health Centers (FQHCs) will be key players on the primary care side for our patients. FQHCs will screen for and even provide some SUD/MH services. They'll refer some patients to specialty agencies for more in-depth treatment, while providing some medication management along with treatment for co-occurring illnesses such as diabetes, depression, heart disease, and chronic pain.

So how will information flow back and forth between an FQHC and a SUD specialty agency? In some cases it will be through a common electronic health record (EHR). In many cases, the two agencies will have different EHRs. In yet other cases, the FQHC will have an EHR and the SUD agency won't. But in all these cases, one thing is true. Patients will receive better treatment if each agency knows what the other is doing. The substance abuse confidentiality regulations such as 42-CFR Part 2 present a challenge to this information sharing. Electronic registries offer one way to partially meet this challenge.

Registries are cool because they can work with all sorts of record systems, electronic and otherwise. What's more, they're not very expensive to develop and operate. I'm not saying they're cheap, but they are reasonably priced. Providers at all sites can enter data on services provided and patient response. With patient permission, that information can be easily shared across sites. The registry can send an alert if the patient is not responding well. For example, when an FQHC refers a patient to an SUD specialty agency, the registry provides a convenient means for transferring important information as part of care coordination.

These data can be used for a variety of populations and patient-specific purposes including tracking and status monitoring. Providers could enter treatment, adherence, and response data on a routine basis and have it displayed (numerically and graphically over time) for not only the SUD but also for key co-occurring illnesses.

The registry could also analyze data. From the registry, both agencies can easily aggregate and examine information about their patient population in several different ways (i.e. by patient, health problem, appointment dates, attendance at medical appointments, medication adherence, and behavioral adherence, over time and within a certain period). For instance, the registry could examine the full list of patients; print out a summary table of their status (e.g., appointment attendance), and identify patients needing attention.

Alerts. Providers could receive summary data before a patient's visit along with notifications if patient's indicator exceeds pre-defined thresholds. This would allow a timely intervention.

Treatment communication. The registry can store data on key treatments and outcomes at and between FQHC or SUD specialty visits and automatically share that information between agencies.

It's easy for an engineer who knows nothing about treatment to say, but these capabilities seem pretty important. If you agree, it might be useful to explore an electronic registry. I bet a lot of you already have. If so, share your thoughts with us.

Dave Gustafson
Director, NIATx

The NIATx Story Database - A great resource just got easier

One of the most popular resources on the NIATx website is our collection of stories. Reading another organization's story and learning from their experience is a powerful tool. And with almost 3,000 participating NIATx organizations we've collected a fair amount over the years. But sifting through all those stories to find the ones most valuable to you and your situation can be a chore. So we've added some features to the NIATx story database to help you find what you're looking for.

In addition to being able to search the database you can refine your search by aim, level of care, NIATx initiative, and story type. You can also sort your results by state, organization, and story type.

So, if you're in need of some inspiration or feeling stuck, visit the NIATx story database. With over 500 stories it's a great resource.

And we're always looking to add new stories. If you have a story to tell, visit our Share Your Story page for detailed instructions.

8th Annual INEBRIA Conference - REGISTRATION IS NOW OPEN!

8th Annual INEBRIA Conference: September 21-23, 2011
Boston, MA, USA

REGISTRATION IS NOW OPEN!
Early bird reduced rates available until July 15
Please register at: http://inebria2011.jbsinternational.com/Register.aspx


September 21: Implementing and Sustaining Alcohol and Other Drug Screening and Brief Intervention (AOD-SBI) Meeting: Lessons from Large Scale Efforts
September 22-23: INEBRIA Conference – New Frontiers: Translating Science to Enhance Health
At the Liberty Hotel, Boston, MA

These conferences will communicate new findings from research on screening and brief intervention (SBI, also known as early identification and brief intervention, EIBI), foster professional collaborations, and facilitate the development and dissemination of SBI research with a particular focus on implementation and sustainability.

To register for the conference, go to: www.inebriaboston.org or http://www.bumc.bu.edu/care/inebria/.

For more information contact: info@inebriaboston.org.

SAMHSA Business Operations Webinar - HIT: Overview of CMS Final Rule on Meaningful Use and Gap Analysis

Thursday, May 26
2:00 pm EST/1:00 pm CST
Register for this webinar

This session will provide an overview of the CMS rule on Meaningful Use and Medicare and Medicaid Provider Incentives for the use of health information technology.

The session will review which providers are eligible for incentive payments and review the specific Meaningful Use Criteria that must be met in order to obtain Medicaid and Medicare Incentive payments.

The presenters will identify how this information can be used to conduct a gap analysis and implement a plan to meet Meaningful Use.

Speakers:

Michael R. Lardiere, LCSW
Director HIT; Sr. Advisor Behavioral Health

National Association of Community Health Centers
mlardiere@nachc.com

Susan Chauvie, RN, MPA-HA
Vice President, Quality for Practice Transformation
OCHIN
chauvies@ochin.org

Michele Russell
Vice President, Business Development
Health Choice Network
MRussell@HCNetwork.org

Angela Strain, GPC
Organizational Advancement Director
CHC Alliance / AHIT
angela@chcalliance.org

Click here for more information on the Business Operations for Behavioral Health Collaborative.

Organizing your process improvement resources with My NIATx

Use My NIATx to organize your favorite resources and stay up to date with the latest NIATx happenings.

The NIATx website is a deep and rich resource, with information, tips and inspiration to help you implement and sustain change within your organization.

With so much available, we wanted to provide a way to easily organize the resources you use the most.

The My NIATx page allows you to save your favorite documents or web pages in a single place on the NIATx website. It's your "go-to" page for the latest NIATx news, upcoming events, and posts to the NIATx support forum.

For more information, view the My NIATx Tutorial.

And let us know what you think. Leave a comment on this blog post or send us an email .

SAMHSA Business Operations Webinar - HIT: Benefits & Economies of Scale in Working with an HCCN

Thursday, April 28, 2011 at 2:00 pm EST/1:00 pm CST

Register for this webinar

There are a number of functions that are required when implementing health information technology, including:

• Training
• Systems back up
• Template design
• Server maintenance and upgrades

Providers have a choice of taking on these responsibilities themselves or working with an organization that can leverage existing relationships and competencies to provide these services. Health Center Controlled Networks (HCCNs) provide Economies of Scale that individual organizations cannot.

This session will provide examples of how providers working with an HCCN can benefit from these economies.

Register for this webinar

---

The National Council for Community Behavioral Healthcare, the National Association of Community Health Centers, NIATx, and the State Associations of Addiction Services have come together with SAMHSA funding to form the Business Operations for Behavioral Health Collaborative.

Its mission is to provide cross-cutting, high quality training, educational opportunities, and resources for service providers to implement efficient and cost effective business solutions.
The four primary training areas are:

• Health Information Technology
• Billing Operations
• Compliance
• Patient Eligibility/Access

8th Annual INEBRIA Conference - Call for Abstracts, Workshops and Symposia

8th Annual INEBRIA Conference: September 21-23, 2011
Boston, MA, USA

ABSTRACT, WORKSHOP, AND SYMPOSIUM SUBMISSIONS DUE
MONDAY, MAY 30, 2011

These conferences will communicate new findings from research on screening and brief intervention (SBI, also known as early identification and brief intervention, EIBI), foster professional collaborations, and facilitate the development and dissemination of SBI research with a particular focus on implementation and sustainability.

We are seeking abstracts, workshop and symposium proposals in the following categories:

1. Research relevant to alcohol SBI
2. Research relevant to other drug SBI
3. Clinical or Educational Program evaluations relevant to alcohol and/or other drug SBI
4. Sharing of experiential or theory-based/generating insights
5. Interactive workshops

To submit an abstract, workshop or symposium proposal, or to register for the conference, go to: www.inebriaboston.org or www.bumc.bu.edu/care/inebria/

For more information contact: info@inebriaboston.org

Business Operations Webinar: Practice Management Systems and Electronic Health Records

Thursday, April 14, 2011 at 2:00 pm EST/1:00 pm CST

Register for this webinar

Covering the basics of what constitutes a Practice Management System(PMS) and Electronic Health Records(EHR) system, this webinar will provide practical advice on how to identify, evaluate and choose suitable PMS and EHR systems.

It will include lessons learned by the presenters, who between them have produced, chosen and successfully implemented such systems in Federally Qualified Health Center (FQHC) environments.

Register for this webinar

The National Council for Community Behavioral Healthcare, the National Association of Community Health Centers, NIATx, and the State Associations of Addiction Services have come together with SAMHSA funding to form the Business Operations for Behavioral Health Collaborative.

Its mission is to provide cross-cutting, high quality training, educational opportunities, and resources for service providers to implement efficient and cost effective business solutions.
The four primary training areas are:

• Health Information Technology
• Billing Operations
• Compliance
• Patient Eligibility/Access

New Opioid Treatment Provider Learning Collaborative

CSAT has made technical assistance available for as many as 20 publicly funded Opioid Treatment Programs (OTPs).

The selected programs will participate in a learning collaborative and receive coaching, training, and support in using process improvement tools to improve access to and retention in treatment.

Please join us for an informational call Thursday, March 31 at 2pm ET/1pm CT/12pm MT/11am PT.

Call-in number: 1-866-642-1665
Passcode: 821938#

Sample results from OTPs that participated in the first Opioid Treatment Provider Learning Collaborative include:

• CAP Quality Care of Maine increased completed screenings by 56%


• Seven Hills Behavioral Health of Massachusetts reduced waiting time to treatment by 50%


• St. Vincent Catholic Medical Center’s OTP in Brooklyn, NY, increased admissions by 53% over the previous year, resulting in an increase in census and revenue

For more information including how to apply, visit www.niatx.net.

Finding the perfect Summit workshop

With all the change going on in the world of healthcare it's no surprise that this year's Summit will focus on preparing for healthcare reform. Once again we've put together an impressive list of speakers and workshops for you to attend. But with all the different workshops sometimes it's hard to know which one will be most beneficial to you and your agency. To help you choose, we've created a couple new tools on the Summit and NIATx websites.

First, the NIATx Health Reform Readiness Index is an easy-to-use online assessment of 13 conditions that an organization needs to thrive in the new healthcare environment. Complete the HRRI anytime before the NIATx Summit and SAAS National Conference. An online report will tell you what conditions you need to work on.

Next, go to the list of conference workshops on the Summit website. By selecting the HRRI conditions that apply to your agency you'll see a list of workshops most relevant to you. We'll also list workshops by HRRI condition in the conference program to help you plan your day.

We hope you'll find these tools useful and look forward to seeing you in Boston.

Request Prior Authorization

Once you identify clients that can have services paid for by a third-party, it's important to know that most plans also require prior authorization for services. Prior authorization is the process of obtaining approval of coverage for a service or medication with a specific provider and network.

Since most third-party payers now require you to get authorization before you deliver services, it is common for a client's bill to be based on the treatment and services that the payer allows.

But what information do you need to obtain authorization? Information requirements vary for each payer. Some companies will authorize an initial course of four to six outpatient sessions with minimal information. Others may want a full bio-psycho-social evaluation and diagnosis before authorization. Find out by talking to the provider relations service representative for the third-party payer, and then create a checklist so that your clinical or intake staff are guaranteed to collect the information needed for authorization. Frequently, the clinical team must actually see the prior authorization for the inpatient stay. For outpatient treatment, prior authorization may be completed prior to the first session. Always check the third-party payer's website for guidelines and expectations for the services provided. And remember, using their terminology will assist in getting services authorized.

Questions:

Does your agency currently have a process for obtaining prior authorization? If so, what is the most difficult or time-consuming part of the process?

Do your clinicians prefer tailoring a treatment plan around services allowed by payers? Or do they prefer creating their own treatment plans regardless of prior authorization guidelines? If they prefer creating their own, how do you get services without prior authorization paid for?

Verifying Patient Insurance Coverage

Many treatment agencies are realizing the benefits of working with third-party payers. The collected fees can stabilize income flow, making it easier to provide charity care to a larger population. But even more agencies struggle with this process.

What happens when a client with insurance comes to your agency? Since you probably already gather information from clients at first contact, you can add another question to the process: Do you have insurance? You should ask the next client that says "yes" to bring their insurance card to their first appointment.

The first step of efficient billing is to learn everything you can about that client's coverage. Check the back of the patient's insurance card for contact information. You'll also need to know:

. Primary care physician information

. Total benefits covered

. Calendar year and lifetime max status

. Deductible: any met, and if yes, how much?

. Co-pay for all levels of care

. Claims address

. Certification (pre-authorization) phone number

. Lifetime maximum amount met

. Policy termination date

. Effective date

. Authorizations required

. Name of person you spoke with

These are simple, yet important, first steps in starting a third-party collection system. Does your agency collect from third-party payers? Do you gather all of the information listed above before or during a client's first appointment? Is there any reason why you cannot make this part of your agencies intake process? Please leave your comments, questions and stories below...