APA MEMBER SURVEY AUGUST 2020 - RCPA

APA MEMBER SURVEY
    AUGUST 2020

•   The survey was designed to measure the impact of the APA
                 on members, as well as identify strengths and future
                 opportunities

             •   The survey was constructed through member inquiries, and
                 feedback and guidance from HealthChoices BH-MCOs

APA Survey   •   The APAs were offered and provided by all 5 BH-MCOs

 Overview    •   The survey outcome and your feedback will be presented as
                 part of RCPA’s efforts with our stakeholder community for
                 future APA initiatives

             •   The survey results represent responses from 41 RCPA
                 member organizations across the continuum of services;
                 representing hundreds of program sites that work with
                 thousands of Pennsylvania’s most vulnerable clients and
                 families

Did your
                  Yes
    agency        98%
 participate in
an APA during
  the crisis?
                  No
                  2%

Has your
   organization       Yes
applied for and/or
   received any       86%
  COVID relief
funds (PPP, Cares
Act, etc.) to cover
your extraordinary     No
  costs related to
     COVID?
                      14%

Have there     Yes
been changes    7%
to your payer
mix since the
COVID crisis     No
   began?       93%

Alternative
 Is your APA        Payment
considered an
  Alternative        65%
Payment or an
  Advanced      Advanced Payment
   Payment?           35%

Are You Currently Utilizing an APA ?

Yes                   93%

No                      7%

APA provided
                       platform for       Ability to sustain
                    continued program    critical services for
                    operations in view        vulnerable
                    of reduced revenue       populations
Reasons why your
agency opted into
    the APAs          APA replaced          Allowed for
                     previous billing    maintaining staff
                       procedures        complements and
                       temporarily         infrastructure

What Programs Do Your APAs Cover
                            APA Covered Programs
    MH OP

  D&A OP

  MH Resid

 D&A Resid

   Case Mgt

  Partial Prg

BHRS/IBHS

 IDD Resid

   IDD CB

      Other

                0%   10%   20%          30%        40%   50%   60%

Did your agency utilize an APA prior to Covid-19
                           Programs Utilizing APAs Pre Covid-19
                           ◦ CSBBH
              27%          ◦ School-Based Behavioral Health
                           ◦ Blended Service Coordination Program
     73%                   ◦ Case Management
                           ◦ Psychiatric Rehab
                           ◦ First Episode Psychosis (FEP)
                           ◦ Community Integrated Recovery Center
        Yes     No

Potential Reconciliation Process Challenges
 Reconciliation versus actual services provided
 Funding based historical service delivery versus
  current service delivery
 Potential CARES and PPP funding offsets
 Some BH-MCOs not requiring reconciliations
 Some BH-MCOs have yet to decide if reconciliation
  will be utilized
 Status of future reconciliations

◦ Funding to ensure sustainability of services
            ◦ Clients’ needs addressed without break in
 What has     services
            ◦ Created predictability and provided the
  worked      flexibility to focus on clients and safety rather
              than survival

 well for   ◦ Ability to modify treatment service delivery,
              including telehealth

your APA?   ◦ Maintained staffing and program infrastructure
            ◦ Saved Community and Ambulatory services
            ◦ Relieved financial stressors
            ◦ Prevented additional losses
            ◦ Timeliness and Flexibility of the BH-MCO

Uncertainty     Funding New
                       With           Programs
                   Reconciliation      During
                      Process        COVID-19
 What have been
  some of the        Services
                                       Tracking
 challenges with     Delivered        Different
                    Above APA       Payor Funding
The APA Process     Thresholds

                   Federal/State
                                    Continuation
                     Funding
                                      Plans?
                     Offsets

Yes
Would you like   98%
 the APAs to
  continue?      No
                 2%

•   BHRS/IBHS
              •   Outpatient MH and SUD
   Member     •   FBMH
 Responses:   •   Case Management
              •   Partial Hospital Program and CSBBH
              •   Peer Support
Programs an   •   Mobile Psychiatric Rehab
APA should    •   EIBI
    support   •   Crisis
              •   All Services

RCPA/Member Recommendations
            Future APAs
APAs that run to                        Develop quality
 December 31,        APA Process         indicators for
   2020 at a       uniformity across     Performance
  minimum          Counties/MCOs          Based Rates

   Consistent          Provider
 reconciliation     engagement in         Revised rate
 process across       future rate      calculations based
                     calculations           on 2020
  BH-MCOs