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Advancing Recovery Payer-Level System Improvements. Baltimore Substance Abuse Systems October 2, 2008 Bonnie Campbell, LCSW bcampbell@bsasinc.org 410-637-1900 ext. 252. Advancing Recovery - Baltimore System-Level Aims. Increase buprenorphine slots
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Advancing RecoveryPayer-Level System Improvements Baltimore Substance Abuse Systems October 2, 2008 Bonnie Campbell, LCSW bcampbell@bsasinc.org 410-637-1900 ext. 252
Advancing Recovery - BaltimoreSystem-Level Aims • Increase buprenorphine slots • Increase # and type of continuing care physicians • Increase patients staying in continuing care for six months • Improve timeliness/efficiency of BSAS approval of provider budget modifications
IMPACT OF AR SYSTEM – LEVEL CHANGE PROCESSES • Increased buprenorphine slots - 181% (new state grant and re-direction of existing funds) • Increased continuing care physicians - 28% • Increased patients in 6-mos continuing care-100% • BSAS organizational improvements • Created staff teams for contracts & budget approvals • Created agency-wide CQI process • Increased provider involvement in developing BSAS policies and procedures
BSAS Change Process - ImprovedApproval of Provider Budget Modifications • Formed Change Team • Change Leader/Facilitator • ADAA-Regional Manager, Grants Section Chief • BSAS-President, Chief of Administration, Finance Director, Grants Accounting Supervisor, Grants Accountant, Chief of Program Operations, Health Program Analyst, Management Information Systems Director • Treatment Providers - 2
Improvement Process • Reviewed data on budget modifications in FY07 (n=32) • Time required for approval (average of 49 days) • Progression of approvals (50% approved “out of order”) • Were actual practices consistent with current policy & procedures (NO) • Flowcharted current actual practices • Identified problem areas • Duplication of effort among staff & providers • Lack of clarity on procedures among staff & providers • Program Analyst review occurred too late in the process • Identified improvements • Reduced time of approval from 49 days to 30 days • Created Routing Slip to facilitate staff approvals • Created new Policy & Procedures and Provider Instructions
Budget Modification - Next Steps • Use new process for 2-3 actual cases • Consider further improvements as needed • Consider more efficient communication methods between provider, grants accountant, and health program analyst • Once procedures are finalized, train all BSAS staff & issue revised provider instructions • Include budget modification instructions in award packets sent to all providers