Care Coordination Forum

1. Care Coordination Forum Traci Kodeck, MPH Vice President, Programs HealthCare Access Maryland www.hcamaryland.org

2. Vision We envision Maryland as a place where all people have equal access to health care and where there are no disparities in health outcomes based on income or race. HealthCare Access Maryland will be a state and national leader in reforming the healthcare system

3. Mission We are making Maryland healthier by connecting residents to insurance and care, educating the community about healthier living and advocating for a more equitable healthcare system

4. HealthCare Access Maryland (HCAM) • Non-profit agency created in 1997 • Formerly Baltimore HealthCare Access (BHCA) • Originally 2 Core Functions • Eligibility • Ombudsman Services/Care Coordination

5. Four Areas of Expertise • Eligibility/Enrollment • System Navigation • Case Management/Care Coordination • Advocacy and Public Policy

6. Key Components of HCAM Care Coordination • Knowledge of the region - resources • Familiarity with public benefits, eligibility and enrollment • Awareness of substance use disorders • Community-based • Cultural competency • Partnerships with key providers • Data driven – qualitative and quantitative • A Flexible Structure • Motivated employees

7. HCAM Model Care Coordinators • Manage referrals • Conduct Outreach • Home Visits • Community • Office • Caseloads 100-125 • Work with clients 6-8 months, longer if needed Management/Finance • Maintain partnerships • Problem Solve • Build Bridges • Data and Billing reports • Audit cases Administrative Support • Process referrals • Manage supplemental service requests and partners • Track insurance and medical appointments • New Role: Billing

8. Management Structure

9. Oversight Director Addiction Outreach Services • Liaison between program and finance • Support • Data tracking • Training • Budget oversight

10. Deputy Director • Direct Supervision: Care Coordination Supervisor • Problem solving difficult cases • Support to Care Coordinators

11. Care Coordination Supervisor • Day to Day Operations of Care Coordinators • Audit of Cases • Monthly Report to County Funders • Point person for providers and RACs • Oversight for Bus Pass Dissemination • Monthly one on ones with staff • Reconciliation of case management database and SMART • Troubleshooting complex cases • “Other Job Duties as Assigned”

12. Lead Care Coordinator • Partial Case Load • Bus Pass Dissemination • GPRA Surveys to ADAA • Troubleshooting with Staff • Weekly Follow up GPRA List • Includes Date Completed AND Date Billed

13. Data Manager • Reports to funders • Denied Claims report • Monthly Dashboard • Reconciliation of Quarterly Incentive Report

14. Administration • Referrals • Assist with Bus Pass Dissemination • Ordering of Gap Services as needed • Birth Certificate and ID oversight • New role: Billing

15. Finance • Oversight of Expenditures vs Revenue • Reforcasting budgets • Oversight of Billing

16. Incentives ATR • 80% completion rate: $10 per GPRA • Completed within month 5/6 an extra $5 • If someone closed 100 cases and completed 95 GPRA’s, they are at 95% and would get $950 JCCP • 75% clients to 2nd Level of Care within 30 days: $10 per client • Successful re engage 30% of clients who left AMA: $10 per client • If 10% of cases close in SMART they will forfeit incentive

17. Challenges • Administrative Procedures • Double Work due to 2 systems • Billing vs High Case Loads • Dueling Priorities • Population

18. Lessons Learned • Weekly reconciliation • Assistance with Billing • Supporting the Care Coordinator

19. Questions? Contact Information Traci Kodeck, MPH Vice President, Programs tkodeck@hcamaryland.org 410-649-0521