4. Global Priorities of Managed Care
1. Provider relations… How many?
2. Rate rationalization
3. Improve access and outcomes
4. Budget predictability
5. Program sustainability
6. The Transition to Managed Care
• Contracting challenges
• Three different MCO’s processes
• Competition for staff w/ MCO’s
• Rates set at average of 2014 level
• Increased costs to our agency
• Service authorization challenges
7. Current State of Transition
o MCOs continue to struggle to manage
within budget constraints. The system
was objectively underfunded
o Getting services right and authorized
has been a challenge
o Significant changes and challenges for
persons served
o Continued payment reform
8. Controlling Our Destiny
• Maintaining organizational equilibrium
• Provider management – be at the
table, consider partnerships
• Rate rationalization, hard to impact.
• Improve and measure quality and
outcomes
• Ensure strong legislative relations
9. To Do: Before Managed Care
• Shore up legislative/departmental
relationships
• Invest in infrastructure
• Work on quality indicators
• Identify Trending
• Seize opportunities and beyond
10. Lastly….
• Redouble your commitment, the big
“Why”
• Be flexible, creative, and innovative
• Take care of your DSPs
• The arc of change is long
• Advocate