Beyond services, learn the 5 major components to this industry change
1. Service Transition
Many groups are not large enough or diverse enough to provide the services required by S. 264. However, many groups will want to grow to become a CCBHC due to the enhanced CMS payments. To meet these four service requirements, organizations may need to expand their operations or acquire or merge with other organizations to augment their service offerings.
2. Care Coordination
Providers must ensure seamless transitions for patients across the full spectrum of health services, including acute, chronic, and BH needs. Effective care coordination allows physical and behavioral care to balance, thus providing the best outcomes. This is achieved through sharing of comprehensive healthcare information.
Once the clinic has been certified, it must solicit the input of its consumers and family/caregivers to determine the staffing requirements to meet its needs. This feedback will be used to update the staffing assessment at least every three years that the clinic is certified. However, clinics will probably want to perform this analysis more often than every three years because changes will need to be factored into the Prospective Payment System (PPS) cost report. This ensures the PPS rates are sufficient to cover the cost of care provided.
CCBHCs have a high level of reporting requirements within two specific areas; quality metrics and cost metrics. Clinics will need to generate cost information to support their PPS calculations in order for their revenue to cover their costs. Quality metrics will be required to justify the CCBHC certification, and are necessary for recertification every five years. They will also be necessary to qualify for the quality bonus payments from CMS.
5. Data Sharing
Information exchange will be critical to the success of any CCBHC. The services required for a CCBHC necessitate that providers share information among their peers in the clinic to ensure quality outcomes over the life of the consumer. If DCOs are used, the processes will also need to include sharing that information bi-directionally with one or more external entities. Current Health IT solutions do not excel at this level of information exchange, so clinics will need to start preparing early to ensure success.
Transition intelligently with the right expertise and tools
Having both BH and medical information in one record is not common, but it's possible. The comprehensive, integrated, and interoperable behavioral health EHR from NextGen Healthcare delivers this in a single platform. Enjoy a fully integrated EHR and PM with intuitive BH content and workflow tools.
The NextGen® BH solution can help your clinic improve care outcomes, streamline data sharing and access, reduce costs, and make reporting easier. With it, you'll have the foundation you need to become a CCBHC.