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Montana Fee-for-Service Project

Montana Fee-for-Service Project. Programs: FY 2010 Admits * District II 160 Gateway 268 Southwest CDS 169 W. MT Addiction Services (WMAS) 653 South Central Mental Health Center 326 Butte Silver Bow CDS 191 MCDC** 685

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Montana Fee-for-Service Project

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  1. Montana Fee-for-Service Project Programs:FY 2010 Admits* District II 160 Gateway 268 Southwest CDS 169 W. MT Addiction Services (WMAS) 653 South Central Mental Health Center 326 Butte Silver Bow CDS 191 MCDC** 685 *State Fiscal Year July 1 2009 to June 30 2010 unduplicated Admissions ** MCDC – The Montana Chemical Dependency Center is the State-run Inpatient Program

  2. AIM Our initial aim was: • To increase third party payments from 16% of the total to 20% of the total. This became: • To move the seven participating programs toward a better understanding of their financial situation.

  3. CHANGES • Programs found business opportunities by looking at: • How could they improve their billing practices? • How could they adjust their rates? • Who are the large employers in their area? • Who are the insurance companies for those employers? • What would it take to become a preferred provider? • Is the insurance company willing to negotiate on any of their standard policies?

  4. RESULTS • Overall for 7 participating programs: • Third party payments increased from 21.8% to 23.5% (7.8% increase). • Selected Providers: • Southwest increased 3rd party billing by $2,600/month. • District II negotiated use of LAC instead of PhD’s; and became preferred provider for Burlington Northern 's insurance company. • Butte/Silver Bow raised rates for a 10% annual increase. • Gateway changed invoicing to add $2,000 / month. • WMAS increased 3rd party billing by 18%.

  5. In Summary Next Steps Explore Joint Ventures to: 1. Approach insurance companies and plan administrators. 2. Manage the back room activities of small programs that might benefit from economies of scale. 3. Provide continued training in fiscal management using the Dashboard. Impact and Lessons Learned: • Better understanding of financial situation. • Increased revenue. • Skepticism regarding changes in healthcare financing.

  6. Montana NIATx Leadership Chemical Dependency Bureau Joan Cassidy, Chief CDB Pat Osterhout, Administrative Officer CDB Ken Taylor, Program Officer CDB Convener State Consultant Peg Shea, MSSW NIATx Coach Elizabeth Strauss, MS

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