Role of Case/Care Management among MeHAF’s Clinical Implementation Grantees

1. Role of Case/Care Management among MeHAF’s Clinical Implementation Grantees Update of Cross Site Information for Case Study

2. What is the Maine State Insect? • Honey Bee • Lady Bug • White Pine Weevil • Striped Cucumber Beetle • Onion Maggot

3. Approximately 50 millions pounds of lobster is caught off the coast of Maine each year. Roughly what percentage of the nation’s lobster supply does this represent? • 50% • 60% • 70% • 80% • 90%

4. Which mental illness was listed as one of the top 10 leading causes of death among adults in Maine in 2010? • Parkinson's Disease • Alzheimer's Disease • Dementia • Suicide/Depression • Anxiety

5. What do we mean by case/care management? Case/Care Management is a general term that refers to an array of enabling and supportive services provided by either a dedicated person or a team that help to ensure that 1) patients receive the care they need, 2) patients are fully engaged in their care, and 3) care is well coordinated.

6. What do we mean by case/care management? Case/care management involves a range of activities including: 1) assessment and screening activities; 2) health education and promotion; 3) appoint reminders/follow-up, 4) care coordination activities, 4) linkages and coordination with community services and supports; and 5) and chronic disease management/self-management support services.

7. With this definition in mind, how important do you think these services are to the success of integrated PC/BH approaches? • Very Important • Somewhat Important • Not Very Important • Not Important at All

9. Do you currently provide any of these services/ activities to your integrated PC-BH patients either through a dedicated case/care manager or another staff member(s)? (Check all that apply) • Risk Assessment and Screening (Health/social risk factor assessments, condition/disease specific screening tools) • Patient Education and Health Promotion (Outreach and awareness campaigns, Basic discussion of conditions and their impact, discussion of risk factors, etc.) • Treatment Support and Counseling (Care planning, motivational interviewing, chronic disease follow-up, behavioral modification, etc.) • Care Coordination, Patient Engagement, and Clinic Operational Support (Referral management, appointment reminders, no-show follow-up, outreach/identification, linkages with community supports and services)

10. For those of you who do provide any of these services/activities, what types of staff members or clinical providers are involved in delivering these services/activities? (Check all that apply) • Dedicated case/care manager • Front-desk/referral clerk/administrative staff • Medical assistant • Nurse • Primary care provider (PCP) • Social worker (Other than case manager) • Other

11. For those of you who have a dedicated case/care manager(s), how many patients should you have in your practice for each full-time case/care manager? • < 1,000 • 1,001 – 2,000 • 2,001 – 3,000 • 3,001 – 4,000 • 4,001 – 5,000 • 5,001 – 7,500 • 7,501 – 10,000 • Don’t Know

12. For those of you who have a dedicated case/care manager, what is the average panel size for a full-time case/care manager at any given time? • 0-15 • 16-25 • 26-50 • 51-75 • 76-100 • 100+ • Don’t Know

13. Have you ever billed for and received reimbursement from private or public insurers for any of these case/care management services? • Do not provide any of these services. • Yes, I bill for and get reimbursed for these services when provided by a masters or higher-level behavioral health specialist. • Yes, I bill for and get reimbursed for these services when provided by other medical staff (other than masters BH). • Yes, I have billed for these services, but have not been reimbursed for the majority of the billed services. • No, I do not bill for and get reimbursed for these services.

14. If yes, who has reimbursed you for these services. (Check all that apply) • MaineCare • Medicare • Anthem Blue Cross & Blue Shield/Wellpoint • Aetna • Cigna • Harvard Pilgrim Health Care • United Health Care • Bundled or global fees (PCMH, etc.) • Federally-subsidized (FQHCs, Rural Health Centers) • Other

15. If yes, what billing codes have you used? (Check all that apply) • Mental Health Service Codes (90801-90862) • Health and Behavior Codes (96150-96154) • Smoking Cessation and Preventive Medicine Counseling Codes (99406-7; 99401-99403) • Other Revenue Codes for FQHCs or Rural Health Centers, including HCPCS codes • H Codes Under Section 65 (H2000-H2010) • Other Codes