Over a year after the effective date of Ohio Managed Care kicked in, Barnes Dennig connected CFOs of local mental health organizations to discuss, “where are we now?” in relation to Behavioral Health Redesign (BHR). This was one in a series of Barnes Dennig’s recurring luncheons to connect financial decision makers together for knowledge sharing, support and thought leadership on industry challenges and trends.
The overarching theme of the discussion was that the BHR system remains in disarray, and the solutions to current problems are often out of the control of local agencies. Some of the top struggles in BHR today are similar issues to those from a year ago when BHR first went into effect. Some of these issues include:
- It’s clear that Managed Care Organizations (MCOs) weren’t ready for the changes and to this day do not have all the bugs fixed. This includes instances of errors and limitations in accepting and processing claims and no or inaccurate reporting or reconciling functions.
- Delays continue for information processing and payments. Whether it relates to client or provider setup, turnaround time for processing changes is less than desirable. These delays contribute to the overall untimeliness of remittances from MCOs. MCO payment lags vary greatly based on agency testimonials. Are you trying to manage and predict your daily cash inflows in relation to claim submissions? Good luck!
- Corrections are plentiful and highly manual. To put it plain and simple, local agencies have logged (and continue to log) a lot of hours corralling information from MCOs, investigating denials and manually updating billings. Recurring meetings, phone calls and direct communication with MCO liaisons seem to be the best route for making forward progress.
Beyond the struggles with MCOs, there are other byproducts of BHR that are affecting local agencies, including:
- Employee turnover. While mental health organizations have never had it easy in this area, turnover rates locally and state-wide continue to balloon. The cost of internal onboarding coupled with periods of lost billing potential results in a difficult juggling act to keep continuity of client service as well as meet cash flow demands. Nonprofits have a difficult time competing with area hospitals and health networks for skilled and licensed staff.
- Employee productivity. While this goes hand-in-hand with employee turnover rates, many have seen a dip in internal productivity.
Suggest a Topic
Our next luncheon will be held in the spring of 2020. Do you have a topic you would like to discuss with the group? Please contact Rachael Cruse at firstname.lastname@example.org, or by calling 513-241-8313.