D9 - State Implementation of Prospective Payment Systems

Tuesday, April 16, 2024

2:15 PM – 3:15 PM CT

Location: 125/126, Level 1, ACCC

Moderator(s)

Scott M. Banken, CPA, MBA, CCRS

Managing Director
FTI Consulting
Andover, Minnesota

Slides

Workshop Presenter(s)

Cindy Ward, BSN, RN, MBA (she/her/hers)

Managing Director
FTI Consulting
Phoenix, Arizona
BB

Bob Blaauw

Program Manager - NYS CCBHC Project Team
New York State Office of Mental Health
Gregory Lovell, MBA

Health Care Facilities Coordinator
New Jersey Department of Human Services, Division of Medical Assistance and Health Services
Trenton, New Jersey
NC

Nick Carideo

Behavioral Healthcare Delivery and Payment Reform Strategist
Minnesota Department of Human Services

Presentation Description: State adoption of PPS payment, either through a state plan amendment or through the national demonstration. We'll discuss the best practices and not-so-great stories of states adopting PPS for CCBHC reimbursement. We will talk about paying directly, through managed care, wraparound payments, directed payments, non-risk arrangements, monitoring cost reports and DCO agreements and collecting data for reporting for the federal Demonstration.

Learning Objectives:

Discuss how to implement PPS in managed care, including contracting, wraparound payments, encounter data reporting, payment reconciliation and key performance metrics.
Identify best practices for PPS payments and reporting for the Demonstration and for SPA accountability.
Explore how to easily find cost report errors, meet the minimum requirements of cost report oversight and best practices for maintaining program integrity for your CCBHC program.