[PC-BH-Integration] Financing Issues
Kathy Reynolds
reynoldk at ewashtenaw.org
Wed Feb 18 15:39:26 EST 2009
Just an FYI.....Liz Reardon and I will be doing a special workshop at the National Council conference in San Antonio on financing entitled: Financing Integrated Health Care: Short Term Solutions to Long Term problems. While we work on advocating for change in the systems, we actually found about 10 ways to fund integrated health care under existing regulations in fee for service and capitated states (10 total, not ten in each funding sources). Please join at the workshop to learn how to do this....and Jody, please attend to help us help folks figure this out in their states!
My whole approach is that financing IS NOT a barrier. There are ways now that we can do this while we're waiting for policy change. Join us in San Antonio to here how!
________________________________________
From: pc-bh-integration-bounces at lists101.his.com [pc-bh-integration-bounces at lists101.his.com] On Behalf Of pc-bh-integration-request at lists101.his.com [pc-bh-integration-request at lists101.his.com]
Sent: Wednesday, February 18, 2009 12:00 AM
To: pc-bh-integration at lists101.his.com
Subject: PC-BH-Integration Digest, Vol 49, Issue 15
Send PC-BH-Integration mailing list submissions to
pc-bh-integration at lists101.his.com
To subscribe or unsubscribe via the World Wide Web, visit
http://lists101.his.com/mailman/listinfo/pc-bh-integration
or, via email, send a message with subject or body 'help' to
pc-bh-integration-request at lists101.his.com
You can reach the person managing the list at
pc-bh-integration-owner at lists101.his.com
When replying, please edit your Subject line so it is more specific
than "Re: Contents of PC-BH-Integration digest..."
Today's Topics:
1. Re: PC-BH-Integration Digest, Vol 49, Issue 10 (LAPER Marie A)
----------------------------------------------------------------------
Message: 1
Date: Tue, 17 Feb 2009 09:58:33 -0800
From: "LAPER Marie A" <Marie.A.LAPER at Co.Benton.OR.US>
Subject: Re: [PC-BH-Integration] PC-BH-Integration Digest, Vol 49,
Issue 10
To: <pc-bh-integration at lists101.his.com>
Message-ID:
<D2E3EFAF38A13F4A99EFD0E54BEF7949109FB9 at bcsrv311.in.co.benton.or.us>
Content-Type: text/plain; charset="us-ascii"
Jody,
I hope you are hearing from others that your issues are national
ones...related to silo-ed funding that does not support the integrated
models of service delivery we are all trying to deliver.
It is always reassuring to hear that practitioners continue to provide
state of the art, best practices despite the lack of funding, but for
many, this can only go on so long...sustaining best practices without
funding in these economic times are difficult at best.
Our FQHC and specialty mental health program are co-located, and we have
come up with a sustainable funding method to support behavioral work,
despite the inability for the LCSW to bill for all of the services
provided. But it is a HUGE balancing act, and takes a commitment to the
model, and practices by the Board and Exec Dir.
Liz's idea of getting the MHC to let you bill under them is a good
solution (need to convince them it is a win-win for both), but if your
state is like ours, the paperwork requirement to serve someone in the
MHC is a real dis-incentive....however, we do it if it is in the best
interest of the client...
You are welcome to contact me directly, if I can answer any specific
questions you have.
Marie Laper, Benton County, Oregon
-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of
pc-bh-integration-request at lists101.his.com
Sent: Tuesday, February 17, 2009 3:23 AM
To: pc-bh-integration at lists101.his.com
Subject: PC-BH-Integration Digest, Vol 49, Issue 10
Send PC-BH-Integration mailing list submissions to
pc-bh-integration at lists101.his.com
To subscribe or unsubscribe via the World Wide Web, visit
http://lists101.his.com/mailman/listinfo/pc-bh-integration
or, via email, send a message with subject or body 'help' to
pc-bh-integration-request at lists101.his.com
You can reach the person managing the list at
pc-bh-integration-owner at lists101.his.com
When replying, please edit your Subject line so it is more specific
than "Re: Contents of PC-BH-Integration digest..."
Today's Topics:
1. Re: New to List (Reardon, Elizabeth)
2. Re: New to List (Bill Schlesinger)
----------------------------------------------------------------------
Message: 1
Date: Mon, 16 Feb 2009 18:15:23 -0500
From: "Reardon, Elizabeth" <Elizabeth.Reardon at umassmed.edu>
Subject: Re: [PC-BH-Integration] New to List
To: pc-bh-integration at lists101.his.com
Message-ID:
<5ECA525B88314B48870E4AC72E3B9AF202FD941C at EDUNIVMAIL05.ad.umassmed.edu>
Content-Type: text/plain; charset="iso-8859-1"
Hi Jody
First off, you and your FQHC colleagues are to be commended for taking
on a commitment to kids and families - as you've indicated, it's a huge
need and can be pretty complicated to provide.
I don't know where you're writing from, so I'm nor sure what the rules
on billing, etc. are in your area, but in Vermont there's been at least
one example that I know of where the clinician from the mental health
center opened up the kids she saw at the primary care practice as
clients of the MH clinic and so was able to bill for assessment, therapy
and case management to the mental health funder, rather than going
through the FQHC. It's a different arrangement than the one you have now
- you'd basically be a one person satellite clinic in the practice - but
if you worked through your MHC you might be able to provide the services
that your patients and their families need without stressing the billing
capacity of the FQHC.
Of course, there's always complications whichever route you try, but
please feel free to contact me directly if you want to chat further
Take care
Liz
email liz at lizreardon.com
-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com on behalf of Jody
Rowell
Sent: Sat 2/14/2009 10:55 AM
To: pc-bh-integration at lists101.his.com
Cc: pc-bh-integration at nccbh.net
Subject: Re: [PC-BH-Integration] New to List
Hi, our primary care integration with a FQHC is failing. As an LCSW I
am
there for 4 hours a week. I have been providing consultation to the
medical
clinicians, seeing kids and their parents briefly, and hooking them up
with
other MH external services as indicated. Because I am the only child
therapist there it doesn't seem particularly helpful to do a full hour
assessment (90801) to provide a few sessions, especially since there is
an
enormous amount of backlog. In addition, I would need a translator with
me
for a large majority of the assessments and treatment. Currently there
are
over a 100 kids on the shared list. Our MH clinic is billing the FQHC
for
my time. The FQHC is struggling financially and is feeling that they
cannot
continue to pay for my presence even though they find it valuable. I am
not
billing enough to cover my time there. Upcoding through FQHC codes is
nearly impossible because most of the peds are reluctant to do the 10
min
warm transfer because of their own insane schedules.
If I sound a little desparate it is because I am worried that all the
work
we have done combined with the incredible need means we will loose this
project.
Any ideas would be very much appreciate. Jody
On Fri, Feb 13, 2009 at 3:24 PM, Jaffy Phillips <jaffy at pobox.com> wrote:
> Hi,
>
> I've just recently signed up to join this list-serve. My impression is
that
> I am to send an email to this address by way of introduction? If so,
here
> goes:
>
> I've been practicing as a psychotherapist for several years, and am
> currently back in school for a Master's in Public Health, focussing on
> health policy. I have a strong interest in collaborative care, and I
am
> currently working on a research paper for the Massachusetts Health
Data
> Consortium, exploring the barriers to and possibilities for
implementation
> of shared electronic medical records between behavioral and
non-behavioral
> providers in Massachusetts.
>
> Thanks for letting me join in the conversation.
>
> Jaffy
>
>
> Jaffy Phillips, MA
> Psychotherapist in private practice
> Health Policy Intern: Massachusetts Health Data Consortium
> MPH student: Boston University School of Public Health
>
>
>
> _______________________________________________
> Reply to this message to send to the group
> Help can be found at
> http://lists101.his.com/mailman/listinfo/pc-bh-integration
> or call Bob Beckwith at (301) 984-6200
>
--
Jody L. Rowell, MSSW, LCSW, Advocate
Clifford W. Beers Guidance Clinic
93 Edwards Street
New Haven, CT 06511
(203)772-1270 x-238 (203)772-0051 (F)
jrowell at cliffordbeers.org
This email and any files transmitted with it may contain information
that is
confidential under the Health Insurance Portability and Accountability
Act
of 1996 (HIPAA) and is intended solely for the use of the individual or
entity to whom they are addressed. Be advised that disclosure, saving,
printing, copying or taking any action in reliance on the contents of
this
message are strictly prohibited. If you have received this email in
error,
please notify the original sender immediately and no one can make you
feel
either by telephone No one can make you feel inferior without your
consent.
ephone or by reply email and delete the message and any attachments from
your computer.
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: application/ms-tnef
Size: 5452 bytes
Desc: not available
URL:
<http://lists101.his.com/pipermail/pc-bh-integration/attachments/2009021
6/f5bfa5f6/attachment-0001.bin>
------------------------------
Message: 2
Date: Sun, 15 Feb 2009 21:02:46 -0700
From: "Bill Schlesinger" <pvida at WHC.NET>
Subject: Re: [PC-BH-Integration] New to List
To: <pc-bh-integration at lists101.his.com>
Message-ID: <8E1476068BC2440FAC80DAB3DCEE11D1 at DGQV6V61>
Content-Type: text/plain; charset="us-ascii"
I don't know a lot about your situation, but how many Medicaid vs.
uninsured
children does the FQHC see? Is the FQHC aware that they can bill for a
mental health visit and a medical visit on the same day? The FQHC
should be
able to report the Medicaid encounter and then receive the prospective
payment ('wraparound') from Medicaid at their full rate - with no
upcoding
required. Also, beginning in October, CHIP will also provide the
prospective payment to FQHC's. The FQHC is also eligible to apply for
Mental Health Service Expansion (applications just went in last month on
the
latest round) for up to $150,000 a year to cover 'unfunded' mental
health
services.
Bill Schlesinger
Project Vida Health Center
3607 Rivera Ave
El Paso, TX 79905
(915) 533-7057 x 207
(915) 490-6148 mobile
(915) 533-7158 fax
bschlesinger.pv at tachc.org
_____
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Jody
Rowell
Sent: Saturday, February 14, 2009 8:55 AM
To: pc-bh-integration at lists101.his.com
Cc: pc-bh-integration at nccbh.net
Subject: Re: [PC-BH-Integration] New to List
Hi, our primary care integration with a FQHC is failing. As an LCSW I
am
there for 4 hours a week. I have been providing consultation to the
medical
clinicians, seeing kids and their parents briefly, and hooking them up
with
other MH external services as indicated. Because I am the only child
therapist there it doesn't seem particularly helpful to do a full hour
assessment (90801) to provide a few sessions, especially since there is
an
enormous amount of backlog. In addition, I would need a translator with
me
for a large majority of the assessments and treatment. Currently there
are
over a 100 kids on the shared list. Our MH clinic is billing the FQHC
for
my time. The FQHC is struggling financially and is feeling that they
cannot
continue to pay for my presence even though they find it valuable. I am
not
billing enough to cover my time there. Upcoding through FQHC codes is
nearly impossible because most of the peds are reluctant to do the 10
min
warm transfer because of their own insane schedules.
If I sound a little desparate it is because I am worried that all the
work
we have done combined with the incredible need means we will loose this
project.
Any ideas would be very much appreciate. Jody
On Fri, Feb 13, 2009 at 3:24 PM, Jaffy Phillips <jaffy at pobox.com> wrote:
Hi,
I've just recently signed up to join this list-serve. My impression is
that
I am to send an email to this address by way of introduction? If so,
here
goes:
I've been practicing as a psychotherapist for several years, and am
currently back in school for a Master's in Public Health, focussing on
health policy. I have a strong interest in collaborative care, and I am
currently working on a research paper for the Massachusetts Health Data
Consortium, exploring the barriers to and possibilities for
implementation
of shared electronic medical records between behavioral and
non-behavioral
providers in Massachusetts.
Thanks for letting me join in the conversation.
Jaffy
Jaffy Phillips, MA
Psychotherapist in private practice
Health Policy Intern: Massachusetts Health Data Consortium
MPH student: Boston University School of Public Health
_______________________________________________
Reply to this message to send to the group
Help can be found at
http://lists101.his.com/mailman/listinfo/pc-bh-integration
or call Bob Beckwith at (301) 984-6200
--
Jody L. Rowell, MSSW, LCSW, Advocate
Clifford W. Beers Guidance Clinic
93 Edwards Street
New Haven, CT 06511
(203)772-1270 x-238 (203)772-0051 (F)
jrowell at cliffordbeers.org
This email and any files transmitted with it may contain information
that is
confidential under the Health Insurance Portability and Accountability
Act
of 1996 (HIPAA) and is intended solely for the use of the individual or
entity to whom they are addressed. Be advised that disclosure, saving,
printing, copying or taking any action in reliance on the contents of
this
message are strictly prohibited. If you have received this email in
error,
please notify the original sender immediately and no one can make you
feel
either by telephone No one can make you feel inferior without your
consent.
ephone or by reply email and delete the message and any attachments from
your computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL:
<http://lists101.his.com/pipermail/pc-bh-integration/attachments/2009021
5/2628637b/attachment.html>
------------------------------
_______________________________________________
Reply to this message to send to the group
Help can be found at
http://lists101.his.com/mailman/listinfo/pc-bh-integration
or call Bob Beckwith at (301) 984-6200
End of PC-BH-Integration Digest, Vol 49, Issue 10
*************************************************
------------------------------
_______________________________________________
Reply to this message to send to the group
Help can be found at http://lists101.his.com/mailman/listinfo/pc-bh-integration
or call Bob Beckwith at (301) 984-6200
End of PC-BH-Integration Digest, Vol 49, Issue 15
*************************************************
More information about the PC-BH-Integration
mailing list