Consulting Services

By Gary Humble | October 7, 2019 | Pinnacle Partners

What Are Some Takeaways from Ohio’s Behavioral Health Carve In Initiative?

What are Some Takeaways from Ohio's Behavioral Health Carve-In? We are now well over a year from when Community Medicaid Behavioral Health services were carved into the Medicaid Managed Care Plans (MCPs).  For many of our colleagues, MCP carve-in has been a struggle. We are in new environment going from one major payer and one [...]

By Gary Humble | October 1, 2019 | Pinnacle Partners

Managed Care Contracting: Beware of Unintended Consequences!

OK!  You Are Now Contracted with Medicaid Managed Care Organizations (MCOs)!  So, Where does Your Organization Go from Here?! The dust is settling..... the Medicaid MCO credentialing & contracting frenzy is now a distant (or not so distant!) memory for many behavioral health agencies.  So where do you go from here? Much of your organization's [...]

By Gary Humble | August 19, 2019 | Pinnacle Partners

Preparing Your Organization for Managed Care: Develop Your Financial Punch List

As our organizations continue to prepare for the various changes coming to the Community Behavioral Health Medicaid system, it is imperative that you take an internal assessment to gauge your readiness for managed care.  Before your organization contracts with Medicaid Managed Care Organizations (MCOs), it must conduct an internal  assessment to determine your readiness and [...]

By Gary Humble | July 20, 2019 | Pinnacle Partners

Prepare Your Organization for Managed Care: Develop Your Administrative Punch List

As your organization continues to adapt to the various changes implemented in the Ohio Community Behavioral Health Medicaid system, it is imperative that you take an internal assessment to continually assess your organization's readiness for managed care. It makes no sense to have a contract with Managed Care Organizations when your Agency is not prepared [...]

By Gary Humble | June 15, 2019 | Pinnacle Partners

Preparing Your Organization for Managed Care: Develop Your Clinical Punch List

As our organizations continue to prepare for the various changes coming to the Community Behavioral Health Medicaid system, it is imperative that you take an internal assessment to gauge your readiness for managed care. This assessment must be done before your organization contracts with the various Medicaid Managed Care Organizations (MCOs).  Once you've conducted your assessment, [...]

By Gary Humble | April 15, 2019 | Pinnacle Partners

How to Work with Medicaid MCOs? Focus On These Three Areas

To say that the Managed Care carve in of Community Behavioral Health Medicaid services has been fraught with challenges may be a bit of an understatement.  I know that each stakeholder (Ohio Department of Medicaid, Medicaid Managed Care Organizations (MCOs), Community Behavioral Health Centers) is working hard to make sure that MCO clients are seen [...]

By Gary Humble | March 4, 2019 | Pinnacle Partners

Preparing Your Organization for Managed Care: Develop A Long Term Game Plan

 I would venture to say that most organizations continue to operate with a sense of urgency when it comes to the State's Behavioral Health Redesign initiatives, especially in dealing with the managed care carve in implemented July 1, 2018.  To say that the Community Behavioral Health Agencies' collective plates are full, would certainly be an [...]

By Gary Humble | January 14, 2019 | Pinnacle Partners

What Administrative Systems Should Agencies Look to Improve in 2019?

Happy Belated 2019!  To say that many in our industry are glad to turn the page on a turbulent 2018, would be an understatement.  Many organizations have struggled to one degree or another in the implementation of Community Medicaid Behavioral Health Redesign and Managed Care MCO carve in.  And although Ohio Medicaid has recently extended [...]

By Gary Humble | November 11, 2018 | Pinnacle Partners

Early Lessons Learned from Medicaid MCO Carve In: Develop Your Administrative Processes!

Ohio's Community Medicaid Behavioral Health System's services has finished up its first four  months of being carved into Managed Care Organizations (MCOs) . So, what are some early takeaways that Agencies can glean from this event?  Here are five takeaways I see impacting our behavioral health community: This process will take time for agencies to modify [...]

By Gary Humble | July 2, 2018 | Pinnacle Partners

Ohio Behavioral Health Medicaid MCP Carve In: It’s Here! Is Your Organization Ready?

Ohio Behavioral Health Medicaid MCP Carve In: It's Here!  Is Your Organization Ready? Well, that date that so many in our behavioral health system have been preparing for has finally arrived! As of July 1, 2018, your organization will no longer bill the Ohio Medicaid Information Technology System (MITS) system for all Community Behavioral Health Medicaid services. Instead, agencies [...]