and New Performance Outcome Standards

BHST Part One: Performance and Value - Based Contracting

This section focuses on the progress and lessons learned in ongoing discussions regarding Clinical Outcomes Reporting, aligning Standard Operating Metrics Reporting and cadence, and the development and use of a public facing Dashboard to support the streamlining of reporting processes.E

Research of established and emerging approaches to streamline reporting processes continued over this period. The goal is to support provider clinical and billing documentation for commercially insured clients, with as much streamlining as possible. To achieve a streamlined approach, participating agencies must be able to comply with multiple sets of regulations in addition to the new performance outcome standards easily. Establishing relationships and agreements with commercial plans requires exceptionally specialized subject matter expertise and time. Some of the activities that were helpful in realizing the extent and variety of approaches to be considered included weekly meetings to discuss the status and requirements of an array of commercial health plans’ contracting requirements and additional workflow sessions where the team could verbalize into draft(s) the multiple paths necessary to achieve streamlined reporting. In addition to the commercial plans, public reporting processes and options for alignment on Standard Operating Metrics and cadence continues to progress. Under BHST, representatives from the two campus providers starting meeting monthly with BHST staff in April 2021 to discuss and identify meaningful metrics that would set the stage for Value-Based Payment (VBP) contracting and develop processes for streamlining the reporting process. With development of an initial public facing dashboard that captures the standard operations being provided by the campus providers, the opportunity for improvement and refinement of reporting was realized. The goal of this workgroup is to achieve reportable outcome measures that demonstrate the successes experienced by the co-location of mental health and substance use services, along with a housing support service that addresses client transitions that may include homelessness upon entry or exit of campus services. The work experienced a pause beginning in March 2022 while shifts in contracting and program leadership occurred at the Health Care Agency. Tracking toward a more streamlined reporting approach for services rendered that can be informed by clinical outcomes reporting will help to set the infrastructure for best practices aligned with implementation of CalAIM. Currently on pause, we hope to resume this work by the start of 2023.

Mind OC recommends the implementation of the following six essential foundations to achieve the final goal of streamlined reporting processes in Orange County:

1. Executive Leadership Commitment to the Vision – visible top-down support and promotion of initiatives

2. Specific Motivation – VBP, Grants, Incentives

3. IT & Data Infrastructure – Tools, Data Quality, Common Measures, Data Sharing

Mechanism

4. Trust – Data Security and Privacy, apples-to-apples reporting, transparent reporting

5. Coordinated Workflow – team-based care, data access, user friendly tools and workflow

6. Outreach and Engagement – person-centered care, coordinated messages and touchpoints, platform agnostic data points

• Visibility of initial contracts are helpful in setting up first version reporting

• Having the appropriate people at the table is essential to prevent process delays (but knowing who those people are is sometime not possible at the outset!) • Early conversations are needed to set up a true reporting mechanism starting on day one • Encountered reporting limitations as result of multiple record management systems that do not interface