A guest blog contributed by Gary Humble of Pinnacle Partners.
You have heard it said before — “Change is coming.” The truth is, change is always happening around us, whether we acknowledge it or not, especially in the behavioral health industry. From technology to mergers and acquisitions to new therapeutic interventions, change is constantly upon us. Preparing for change, then, is one of our most vital challenges.
The key in working through any change is to continually ask your managers and staff how you are going to incorporate this change for the betterment of our clients and thus, fulfill our organization’s mission?
Nowhere is that more apparent than the behavioral health arena, especially in the community behavioral health agency world.
Back in the day, our behavioral health world was more straightforward — agency staff provided services to clients and the agency itself was financed in a typical grant-based payment system. For many of us, grant-based funding made up between 50-80% of our total revenue budget.
But today, with the advent of managed care, agencies are looking at massive change from both internal and external forces. Nationally accepted billing codes, clinical authorization, negotiating contracts and fee schedules are small examples of the changes that community behavioral health organizations now deal with. No longer will agencies be able to depend solely on the funding methodologies (grant funding) of old. The Managed Care Organization (MCO) paradigm will not only require agencies to look at how services are delivered, it will also require those agencies to demonstrate it’s clinical effectiveness. Organizations must understand that if they are unable to demonstrate effectiveness, they will be supplanted by another that can.
So what are the current agency approaches to the upcoming Managed Care era? There are three camps: one camp will make things happen; one camp watches things happen; and the third camp that is wondering, “what happened”?
I want to focus on that camp that makes things happen. What should agencies be doing right now? As one who loves boating, it is best for a captain to keep an eye on the wheel and another to the horizon. Pay attention to your day-to-day activities (administrative & clinical), always looking to improve efficiency in any area that we control. We as leaders must look to the future (horizon) to see how these state initiatives may affect our organizations. We do this by developing relationships with key people in our universe — managed care executives, state officials, and other behavioral health organizations’ leadership staff so that we can compare notes and make whatever course corrections needed to ensure our organizations are well positioned to benefit from the coming changes.
We need to talk openly about change and its impact on staff. At the same time, we must encourage staff to think creatively about how to incorporate change that will make our clients’ lives better and fulfill the mission of our organizations.
Remember, as W. Edward Deming once said, “It is not necessary to change. Survival is not mandatory.”