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Early Warning Care Monitoring Report
PA HealthChoices Behavioral Health Program
First Quarter - 2000

August 17, 2000

Commonwealth of Pennsylvania
Department of Public Welfare
Office of Mental Health and Substance Abuse Services
Bureau of Operations and Quality Management

The Early Warning Care Monitoring Report is the result of a pilot project co-funded and sponsored by the Substance Abuse Mental Health Services Agency (SAMHSA) and the Health Care Financing Administration (HCFA) in cooperation with the Commonwealth of Pennsylvania, Office of Mental Health and Substance Abuse (OMHSAS). The pilot, conducted during the southwest HealthChoices implementation January 1999, was designed to test a limited set of indicators that would allow "early warning" detection of implementation problems with Medicaid managed care for behavioral health services and of operational programs which have not achieved or have lost stability. The results of quality management initiatives, conducted in response to Early Warning, are reported quarterly from County contractors and the behavioral health managed care organizations. The report incorporates feedback from all stakeholder groups and county Family and Consumer Satisfaction Teams who conduct face to face interviews with HealthChoices members. Stakeholder feedback and actions taken to address their input is reported in Early Warning. The results of OMHSAS telephone satisfaction surveys with network providers are also reported. This report serves as a major communication vehicle for the behavioral health managed care program in Pennsylvania and as a resource to identify state and local quality improvement studies.

In 2000 Early Warning is being expanded to the Southeast HealthChoices counties and will be used during the Lehigh/Capital HealthChoices implementation. Having proven the viability of the indicators and process, Early Warning is no longer a project and has been incorported into the OMHSAS strategy for quality management. In 2000 we will strengthen the reporting of state and local management and quality improvement efforts related to the Early Warning indicators. We will continue to examine these indicators for their effectiveness in measuring the start-up of geographic areas as well as their effectiveness in measuring the program as the managed care systems matures.

As you read the 2000 report you will also see summary information about trends from 1999. This information will help focus attention on the areas that may require more in-depth examination if trending continues into the second year.

Acknowledgements
We appreciate the opportunity to have piloted this project with SAMHSA and HCFA, and the many technical resources and people they made available. Howard Dichter, the SAMHSA consultant, brings independent clinical expertise in data analysis, development of the indicators and development a report format that responds to a varied audience. The southwest counties and their behavioral health managed care organizations helped us revise and improve the measures and are now providing invaluable insight into the meaning of these data and actions they are taking to improve the quality of services. The stakeholder groups and Family/Consumer Satisfactions Teams keep us grounded in the reality of people's lives and experience to help us focus our efforts. Thank you to all.

Authored By:
Howard Dichter, M.D.
Candace Orr
Mary Jeanne Serafin
Linda Zelch

Report Documents

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