Maryland
Develop a Framework to Propose, Organize, and Discuss Categories of Improvements and Specific Ideas to Operationalize the Design PrinciplesImprovement Categories:Case Management ImprovementsData Sharing ImprovementsCost Management ImprovementsBehavioral Health Provider Network ImprovementsAccountability ImprovementsQuality ImprovementsCase Management ImprovementsMCO Extended Case ManagementLocal Systems Management StandardizationRegional On-Call StaffASO Case Management ExpansionOverdose Transitions to Treatment Independent of Participant’s ActionClear, Timely Pathways to Outpatient and Ambulatory ServicesImprove the Capacity of the Medicaid Managed Care System to Integrate with Non-Medicaid State Systems, Populations, and Services (MD Behavioral Health Coalition)Data Sharing ImprovementsCRISP - Point of CareAbility to Search by Medicaid Identification NumberReal-Time, Read-Only Access to ASO DataElectronic Access to Provider Directories, Particularly for Medication Adherence: Provider LettersPrescription Data VisibilityUse Cases for Data Sharing: Immediate Access to Diagnosis and Treatment Information for Case Management and Access to Claims/Prescription Information for Data MiningProvide Prescription and Claims Files in a Traditional Format, e.g., 837Provide Recent Participant Contact Information PBM Data CyclesMake Better Use of Health Information Systems to Improve Data Sharing (MD Behavioral Health Coalition)Cost Management ImprovementsCapitated ASOManaged Behavioral Health Organization (MBHO)High Utilizers: Chronic DiseaseOpioidsDiabetesContracts between ASO, MCOs, and Local Systems ManagersBehavioral Health Provider Network ImprovementsDefine Network AdequacyIncrease Management of the Behavioral Health Provider Network and Ensure Appropriate Enforcement of Current Regulations (MD Behavioral Health Coalition)Improve Referral ProcessesDefine Local Systems Manager RolesIntegrate and Better Define Roles and Responsibilities for Local System Management Agencies (MD Behavioral Health Coalition)Obtain Better Understanding of Provider Types and Scopes of WorkAccountability ImprovementsPerformance-Based MetricsImplement Uniform and System-wide Measurement-based Care Standards for Mental Health and Substance Use Disorders (MD Behavioral Health Coalition)Score CardsStandards of PracticeDefine Who is AccountableQuality ImprovementsMedication Adherence, e.g., MATShared Quality Activities, e.g., HEDIS MeasuresImprove the Quality and Cost Predictability of Care by Expanding Value-Based Payments in Behavioral Health. Ensure Care is Patient-Centered by Increasing Provider Flexibility and Expanding Value-Based, Outcome-Focused Service Delivery Across Systems (MD Behavioral Health Coalition) ................
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