If you are already involved in a public sector managed care conversion, be prepared to shout YES! - or maybe NO! - as you scroll through our no-holds-barred slides and humorous artwork. Who says that Continuing Education has to be boring? Take this course! Avoid the pain of Health Care Reform.
So What's This Course 4A About? 'This is Managed Care - and Its Impact on YOU!' a.k.a. 'It's Not Your Grandpa's Chevy! It's The Good, The Bad, and The Ugly!'
WANT A FAST TO-THE-POINT DESCRIPTION of what's covered in this course? Just hop on over to our course catalog now and take a look. If you want a detailed look at this course, just click the link in the catalog and we'll bring you right back to this page. Or .... just read on!
If you are a mental health or substance abuse treatment provider and are concerned about Managed Care this online Continuing Education (CE) FlexiCourse 4A is timely and relevant. It's inexpensive. It's in a PDF slideshow format.
This online CEU course provides an unvarnished view of what has CHANGED due to the coming of Managed Care to the Mental Health (MH) and Chemical Dependency (CD) / Substance Abuse (SA) treatment fields - including what can go WRONG in Managed Care plans, and what type of Provider Agreements to seek out and which to avoid.
The course also provides specific detail about the 4 core elements which determine your client's eligibility for the service you are requesting, i.e., the 'Medical Necessity of Treatment'. THIS is the main issue with which providers struggle, under the new Health Care Reform! Understand it, today!
This Managed Care Course (FlexiCourse 4A) earns 6.25 credit hours (4.25 for NBCC and BBS). It contains the first 2 modules from FlexiCourse 5A. Bite-sized portions of this course are found in MiniCourses 1B and 1C.
WHAT OTHER COURSES PERTAINING TO MANAGED CARE DO WE OFFER?
CEU FlexiCourse 4A contains the course materials for two (2) separate CE certificates - Module 101 and Module 201.
Module 101- FlexiCourse 4A - Managed Care In Public Health Programs: It's Not Your Grandpa's Chevy!
This PDF slideshow presentation gives you a basic, no-holds-barred introduction to the most common problems occurring in behavioral health managed care programs which are put into place by State Government, such as Medicaid, Medicare, and Substance Abuse (SA) Block Grant conversions . . . coming on strong all over the country.
- Intro to Goals and Objectives of Behavioral Health Managed Care - 'Why Are They Doing This to Us?'
- What can go wrong - at both the MCO end and the Provider end and within the delivery system?
- Understanding RISK BASED MANAGED CARE - 'Capitation' Contracts (the primary type of State Managed Care Contract including Medicaid) - and the MAJOR ways that they impact providers in both clinical and financial ways.
- Intro to the important clinical concerns and opportunities for treatment providers under a managed care contract. back to top
Are there different kinds of Managed Care plans? Yes indeed. There's The Good, The Bad, and The Ugly - for the Managed Care companies AND for the providers! But we don't just throw you out there - we identify those plans that are 'mostly safe' (like Fee for Service and Case Rates) vs. those that are 'nerve wracking' vs. those with 'don't even think about it!' written all over them.
1. Understanding the impact of this new health care approach upon providers.
2. Review of 'What's a Capitation Contract' - the primary type of State-HMO managed care contract used in Medicaid and Medicare managed care conversions. Can it possibly work? Yes. And what about FEE FOR SERVICE?
3. Understanding a couple of other Managed Care designs - one is The Good, and one The Truly Ugly (Watch Out! Run Fast!).
4. And should providers take on ANY of these high-risk arrangements, working as a provider for an HMO? Or as the 'substitute' for an HMO? What kind of risk are they taking? And can they succeed in any of these arrangements? (Answer: Yes.)
5. How does Managed Care affect the way that we deliver treatment to Mental Health and Chemical Dependency clients? Here's some creative service options for treatment providers which allow more autonomy.
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