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Improving Care and Care Management
- One person � One Plan: Develop rules and a process whereby one treatment plan is developed for all services a person receives.
- Compare the costs and benefits of keeping case management as an independent service with the costs and benefits of integrating it with other services.� Evaluate training and qualifications of current case managers to determine whether they should be upgraded.
- Develop care coordination at the front door to improve engagement and build on the DOH Chronic Care Demonstrations.�
- Expand the use of peer or recovery support staff to increase care coordination.
- Increase the emphasis on coordinating consumers� transitions between levels of care, especially following hospital discharge. Use bridgers and peers to help facilitate these transitions.
- Increase training in and support of person centered planning as a vehicle for transforming the system.
- Develop technologies to help counties identify high risk and high need cases for chronic illness management approaches.
Improving Administrative Functions
- Develop billing codes other than case management for the services such as navigation and support that case managers currently perform in their efforts to maintain consumers in the community.
- Develop contract and program performance indicators and increase provider reporting and transparency of data in the system.�
- Implement more routine provider and county reporting for utilization and cost data.
- Find ways to reward rapid response, engagement and retention in care, such as:
- Develop performance contracting guidelines for key service types based upon indicators;�
- Assist counties with their implementation; and
- Consider withholds or bonuses in contracts.
- Reduce bureaucratic requirements for annual cost reconciliation and/or change the methods of contracting and rate setting.
- Encourage, facilitate and incentivize county and regional approaches to restructuring.
- Consider requiring county 5.07 Plans to more systematically address the need for restructuring and regional approaches if needed.
Reducing Regional Variation
- Analyze reasons for regional variation in service penetration and utilization.� Require this as a part of county annual planning.
- Use quality improvement practices to reduce regional variation in practice and utilization.
- Develop utilization management capabilities in the system through the SPOAs or some similar entity.
- Consider ways to encourage county collaborations and multi county initiatives similar to the Pennsylvania and Western New York models.
Supporting Implementation of Person Centered Care
- Increase support for consumer education to improve consumers� ability to navigate the healthcare system and to enhance choice.
- Facilitate the development of pilots in self direction and "money follows the client" approaches.