We wrote just last week about payment reform coming to New Jersey developmental disability services providers. Several years ago, Pennsylvania providers went through this same thing when they changed the payment structure for DD/ID services providers from cost-reimbursement contracts to fee-for-service.
Milestone Centers, Inc., which serves 160 clients in their day program and 75 in the workshop, knew they could depend on Qualifacts to guide them through the transition and help them maintain their ability to serve. Barb Conniff, CEO, shares her advice on what providers can do to prepare for and thrive in the era of payment reform.
Barb Conniff, CEO
Milestone Centers, Inc.
Re-education – for staff AND consumers and their families – is key.
“We have to watch carefully from an administrative perspective, because many services are billed in 15-minute increments or ‘units.’ It’s a big reeducation for everyone on staff! So, the first concern is trying to get everyone to understand how the changes impact the financial health of the organization. Everyone has to be committed to work toward stable units – staff, consumers and families.”
Be flexible enough to change processes where needed.
“We discovered that revenue is impacted despite best efforts – sick days, snow days, etc. – and we made some changes to compensate. Our program used to shut down two weeks a year, but not anymore. We also removed two scheduled holidays and replaced those with additional discretionary PTO days for the staff.
“Also, doing ‘regular business’ in services is a bit of a shock, so you will want to re-do budgets based on unit projections. Even still, you will continue to evolve as you learn over the first couple of years the key indicators to look at, so you can budget more realistic scenarios.”
Take advantage of system functionality.
“The change to fee-for-service was pretty massive, but luckily for us, we were already billing behavioral health services using that method. We had a system set up and knew where the pitfalls were and how to address those.
“Without an efficient EHR and billing system, this process would be impossible to track – hundreds of thousands of units per week! Our ability to capture the units and make sure we have all required signatures, documentation, everything to bill in CareLogic positively impacts our bottom line. Our cash flow is excellent because we get bills in quickly and quickly receive payment.”
Start now.
“July 1 started our fourth year in fee-for-service. We know from experience, the sooner you start planning for the change, the better! Your business processes need to be effective and efficient, so now is the time to clean up your procedures and workflows. A big change like payment reform provides a natural opportunity to make sure your agency is ready for whatever comes next.”
The post Been there, done that: Pennsylvania provider offers advice on DD payment reform appeared first on .
