The transition to Medicaid Managed Care holds the promise of moving the behavioral health system toward the triple aim. It requires many organizational changes, from responding to and managing shifting resources, to shifts in job descriptions and roles to which agencies must acclimate. The result, if the changes achieve the aim, will be reflected in superior behavioral health care, better outcomes for clients, and lower costs.
The New York State Office of Mental Health and Office of Alcohol and Substance Abuse Services (OASAS) have funded the Managed Care Technical Assistance Center (MCTAC) to develop tailored training, tools, and resources to target the work force in a variety of different platforms and capacities. This article addresses the need for technical assistance in any transition and certainly in one as complex as New York State’s transition to managed care. It also provides an overview of available resources for behavioral health providers as they make the transition.
In addition to physical changes such as new forms, new processes, and new technology, the transition requires a change in mindset for all levels—from board members to frontline staff. Board members and executives must conceptualize a shift in their organization’s role, and staff members must be kept informed of how these changes will impact them. Additionally, a result of this shift is ambiguity in a number of areas, and staff should be acknowledged for the changes they are managing, along with the potential instability they experience. In many instances the transition can mean a heavier workload for providers especially as they estimate volume for new services, and build an infrastructure to support the requirements of a new system. To balance this, communication and transparency become critically important to ensure staff and senior leadership alike understand the goals and benefits of the new system as well as the very real impact that health care transformation has on the staff providing services.
As provider type, populations served, and staffing levels vary across the behavioral health field, training must acknowledge and accommodate for this diverse range of needs by offering technical assistance to best engage and support providers using a variety of methods, tactics, and settings. The collaborative partnership of MCTAC involves government, health plans, providers, advocacy groups, academic, and research-based organizations, all of whom participate in a dynamic working partnership in the development and delivery of technical assistance with the common goal of supporting and improving the delivery of behavioral health services in New York State. Training content and priorities are informed by providers in the field, and directly linked with provider needs relating to Managed Care readiness.
MCTAC provides training and resource content through a variety of platforms, including Face-to-Face Presentations and Conferences, Web-Based Trainings, Learning Communities, Office Hours, Tools and Resources, and Self-Learning. Materials from all offerings, including slides, recordings, Q&A, and other developed resources, are available on the MCTAC.org website and circulated via e-mail to newsletter recipients on a weekly basis. This “clearinghouse” function serves to highlight and disseminate information from state partners and other colleagues working to support this system transformation. Additionally, MCTAC has implemented a constant and robust feedback loop through training evaluation forms for all offerings, and the creation of the MCTAC.info@nyu.edu email box fields questions and acts on inquiries from the field. This prioritization of user and provider experience seeks to address training topics and ongoing assessment of specific provider needs.
One of the most critical functions of MCTAC is to provide information. Presentation-based training and learning communities offer one opportunity for this work. Attendees are encouraged to share information and resources with their colleagues and generate new questions and ideas facilitated through informal information sharing or through the establishment of a managed care implementation task force and a more deliberate meeting and support infrastructure.
Tools and resources are another crucial element of this work. These tools, developed in collaboration with the array of state, plan, advocacy and agency partners include a managed care language guide; definition of top acronyms; a plan matrix with information spanning all designated plans in NYC, with update planned for the rest-of-state and children’s implementation; a consultant directory, and many others currently in development. Tools have been developed to save valuable time for providers and plans, and can be readily accessed on the www.MCTAC.org website.
Through its partnership with CASA Columbia, MCTAC is working with OASAS on systems redesign initiatives particularly focused on the residential system, promoting medication assisted treatment, and clinic redesign.
Efforts to support providers and staff extend beyond New York’s largest cities and agencies and will continue to evolve in order to offer support to agencies outside of the state’s large metropolitan areas through tailored tools, self-guided learning modules, and resources, so that all agencies have the support they need and all New Yorkers are able to access quality care.
As MCTAC transitions into the rest of state and children’s implementation the authors encourage providers to familiarize themselves with our tools and previous offerings. All of these offerings and tools will be updated for the upstate and children’s roll outs. Also, please take advantage of MCTAC.info@nyu.edu to share any suggestions for needed technical assistance.
Daniel Ferris, MPA is the Assistant Director, Policy and External Affairs within the McSilver Institute for Poverty Policy and Research, NYU School of Social Work. Meagan Baier, LMSW is a Project Manager and Analyst at the Institute for Community Living. Questions can be directed to Daniel Ferris at dan.ferris@nyu.edu.
