黑料正能量 Note: This astute reflection on the 黑料正能量 Executive Seminar from David Bucciferro听 contrasts a few of the specific opportunities and challenges facing our health system transformation. Moving in a concerted direction is difficult for a field that has always worked in a siloed, disjointed, and often anachronistic ways. Mistakes along the way toward transformation are often made when programs and officials make individual decisions without understanding how the choices fit within the larger system; conversely, mistakes are also made when the proverbial 鈥渇orest鈥 takes over the ability to see individual 鈥渢rees鈥. Finding the balance between the two and moving in a unified direction is where competition and innovation takes place for industry, and where efficiency and progress takes place in policy.
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A New Era of Behavioral Health Systems: Reflections on the 黑料正能量 Executive Seminar
Foothold Technology; David Bucciferro, May 2015
As I sat in the audience of the 黑料正能量 State Association of Psychiatric Rehabilitation Services (黑料正能量) Executive Seminar, I came to the realization that one of the largest efforts to reform the delivery of Medicaid services to some of the most costly users of healthcare in the 黑料正能量 State is about to become a reality. The theme of the seminar 鈥淗ealthcare Reform is Here: What Lies Ahead鈥nd What Really Matters鈥 certainly rings true. This massive undertaking is not the first of its kind, but it is the largest and will have will have far reaching impact. I believe that federal agencies, state authorities, providers and managed care companies are all closely monitoring the positive and negative impacts this effort will have on the recovery of people with behavioral health issues.
It鈥檚 important to acknowledge that the planning, development and initial implementation of the behavioral healthcare system in 黑料正能量 has not, by any measure, been a smooth and flawless planning time. Areas such as technology, the creation of uniform data sets, service integration models, and complexities in running multiple lines of business at a service delivery level were under addressed, not addressed at all, or mishandled. This isn鈥檛 because of incompetence or some motive-driven reasoning, but because the undertaking of something this huge is very complex. As a result, some components of the reform have been rushed and others continue to be delayed, with both scenarios causing some disruptions at the service delivery level.
For example, Health Homes, one of the key components to behavioral healthcare reform in 黑料正能量, were left to their own devices to create infrastructure to manage the complex information that needs to be obtained, exchanged and used among providers. Although specifications were originally set in place, many Health Homes have created archaic or homegrown structures rather than taking advantage of the latest technology and best practices. Care coordination entities like Health Homes must operate systems that have complete interoperability functionality. Sharing information among multiple entities is crucial in creating a new type of behavioral health system that addresses the full spectrum of needs of a consumer. I also believe that if you have multiple Health Homes within a jurisdiction, it is harmful to require multiple, different data sets from agencies providing care. Having to report on different standards becomes a burden to service providers, which causes extra time, resources and ultimately, creates roadblocks to truly value-based services for the consumer.
While 黑料正能量 has had challenges, it has also had successes, in large part due to the dedication of those implementing such a massive reform across such a huge service area. Some of those include:
- The inclusion of stakeholders and those that give consumers of services a chance to participate directly in the planning.
- The creation of technical assistance centers and learning communities to ensure that all parties involved can share best practices and learn from each other.
- Weekly calls with government representatives to ensure consistent and clear communication among stakeholders.
While healthcare reform aims to reduce high service costs, it is also creating a paradigm shift. A shift to a system that includes the best of what already exists 鈥 programs like PROS and peer support and crisis diversion 鈥 and includes greater care coordination, the integration of behavioral health and primary health, peer outreach programs and HCBS waiver services. Through this reform we can create a healthcare system that supports self-driven, recovery-oriented, value-based services and one that is respectful to those receiving services.
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