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Care Team Optimization Resources

Supporting Practice Leaders Navigating Unfamiliar Waters – Leadership Through Change Part 1

Practice leaders face more decisions than ever as the District of Columbia works to build an integrated health system that delivers whole person care. This learning series is designed to help organizational decision makers better manage change within a dynamic health system. Part 1 will introduce ways that leadership can transform ingrained policies and practices using new information, data points, and approaches to improve care access and outcomes. The session will also preview exciting next steps for the learning series moving into 2024.

Value-Based Payment: Is it disrupting health care for the better? Role of a Capitated Alternative Payment Model – FQHC Part 2

This webinar will focus on the “why” of transitioning from fee-for-service to capitation to pay for community health center direct services. Dr. Jones will discuss how fee-for-service reimbursement limits patient access to care and hampers efforts to improve patient self-management and accountability for their own health. He will share examples of how innovators are using lessons learned from other service industries to disrupt the health care market. Participants will learn how moving away from the fee-for-service system can preserve revenue streams but also support new models of care, and how payment reform can help to address primary care workforce shortages.

Engaging Families In Primary Care Behavioral Health (PCBH Series Part 12)

PCBH services not only facilitate change at the individual level but impact the family system. Conversely, family engagement in PCBH services can expedite the achievement and sustainability of an individual’s health goals. Strategies will be discussed that can help enhance family engagement within the PCBH model of care.

Integrated Care DC Managed Care Readiness Workshop

View materials from this event hosted by Department of Health Care Finance, DBH Training Institute, & Integrated Care DC on May 9, 2023. The in-person workshop was designed for behavioral health providers and other organizations seeking to prepare for the integration of behavioral health into the District’s Medicaid Managed Care Program. Presenters shared information and facilitated exercises to help leadership, clinical and operational staff, and other stakeholders develop the organizational competencies needed to succeed in managed care, including an understanding of managed care principles, how to communicate effectively with managed care partners, and how to effectively demonstrate the value of care through quality measurement and population health.

LGBTQ+ Cultural Competency Training Part 1

Lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ+) individuals are frequently underserved and experience significant disparities in health outcomes and accessing preventive and ongoing healthcare. Sexual and gender minorities (SGM) often experience discrimination and bias in health care settings and may delay or avoid medical and preventive care. Developing safe, culturally competent healthcare environments and practices for LGBTQ+ patients is critical and closely related to individuals’ willingness to openly share their sexual orientation and/or gender identity and expression (SOGIE). Capturing SOGIE data is critical as it allows providers to have a more comprehensive picture of key factors that influence care. This session will start with a brief discussion of SOGIE terminology and a compilation of what is known about medical and behavioral health needs and disparities among the LGBTQ+ community. We will highlight the critical need for creating environments that improve patients’ psychological safety and increase their willingness to share SOGIE characteristics. We will share examples of how this data could be utilized to improve care and patient satisfaction, including capturing a patient’s preferred name and pronouns, and ways to engage in respectful conversations that could reveal key aspects of their medical history that could otherwise go unnoticed.

Dosing and Titrating Care (PCBH Series Part 10)

A core skill in caring for patients in primary care is the ability to dose and titrate care for individual patients in a way that produces quality outcomes for the patient and allows a provider to care for populations of patients effectively. This session will increase the mindfulness and skills clinicians employ for dosing and titrating care from within the PCBH model.

Treatment Planning (Quality & Population Health Series, Part 2)

We often think of the treatment plan as a document to complete. However, it can be a tool to engage and empower the person served in their own recovery process. In this interactive webinar we will learn the core components of the treatment planning process from a person-centered and engagement-focused lens.

Guiding: Using Motivational Interviewing Skills to Guide Conversations (Motivational Interviewing Series, Part 2)

There are three main approaches to helping people make a change, directing, following, and a middle-of-the-road approach of guiding. Motivational Interviewing (MI) promotes guiding as an approach to discovering and uncovering an individual’s motivations, concerns, values, and options. This refresher workshop will provide the opportunity to directly practice using MI skills to build discrepancy and move conversations towards enhancing commitment to change.

Quality Measurement Basics: And Why it Matters (Quality & Population Health Series, Part 1)

Understanding, measuring, working to improve quality performance are critical to ensuring that patients have positive outcomes and providers are satisfied—they’re also critical to ensure your practice is meeting its regulatory requirements and maximizing payment opportunities. As the District of Columbia carves in behavioral health care to managed care arrangements and requires more providers to be in value-based care arrangements, it is even more imperative that quality measurement and improvement is understood and infused across your organization—from providers, to leaders, to auxiliary staff. This two-part series will describe the quality measurement basics and why it matters, and then treatment planning for population health. In Part 1, we will explore why we need to infuse a culture of quality within healthcare organizations, including an understanding of what we value, who we serve, and who we are accountable to. Presenters will emphasize the importance of all staff understanding quality and its impact on our patients, staff and organization. We will review the basics of measurement and key measures in quality focused on integrated care.

Is a 20-minute consultation realistic? (PCBH Series Part 8)

In making the transition from practicing outpatient behavioral health to primary care behavioral health, clinicians often wonder, how can I do my work in 20 minutes, and is it really possible to make a meaningful difference in this amount of time? This training answers this question directly by simulating a 20 minute behavioral health consultation and discussing as a group each stage of the encounter, best practices, and the strengths and challenges that arise.

Consent to Share Substance Use Disorder Information: The Basics (Consent Management Series 1)

This session will focus on enhancing care coordination for patients with SUD and the importance of gaining permission to release information. We will review scenarios such as: A 35-year-old patient is seeing her PCP. The patient has Type I diabetes and has been much better controlled since she has been in treatment for OUD for the past 5 years. Recently, the patient experienced some life stressors, lapsed and has not been back to treatment for two weeks. A 60-year-old patient has just recently started treatment for co-occurring depression and AUD after discussing treatment for many years with the PCP. He has hypertension and diabetes, and the alcohol use has been exacerbating these conditions for years. The PCP is concerned about the patient’s ability to stay in treatment as the patient has recently lost his job and is separating from his partner of many years. Staying informed of a patient’s recovery status can impact how you treat other health conditions and is an important component of their overall care. Have you hit barriers when trying to get the clinical information you need care for your patient? Are you aware of the new pathway to obtain this information?  In this session, we will focus on consent management, how to talk with your patients about consent, the basics of 42 CFR Part 2, myth busting, use cases, and FAQs. We will introduce CRISP DC’s Consent Management tool, including a history of its development, gaps it will address, and key features and why this is a priority in the District.

Understanding How and Why Providers and Payers are Using Incentive Payments as a Tool to Improve Integration (Understanding Primary Health Requirements for Incentive Payments Part 1)

We will talk with Dr. Yavar Moghimi, Chief Psychiatric Medical Officer of AmeriHealth Caritas about why integrated care is important and the ways AmeriHealth is working with providers to identify and ultimately achieve key physical and behavioral health outcomes. There will be time for audience questions and answers after a brief interview-style presentation.

Help! We’re so Short Staffed: Best Practices for Hiring and Retaining Your Workforce

Vice President of Human Resources at Mount Sinai Health System in NYC and Dr. Mary Awuonda Associate Professor of Howard University and Dean Mashonda Smith of UDC will be share lessons learned in the district and other large health systems. The aim of the conversation is to talk and learn from one another to develop solutions grounded in the realities of the Washington DC policy, regulatory and health care environment.

Providers Responsibility in Managing Medical Conditions: Making Clinical Improvements & Meeting Quality Metrics

What’s the link between pay for performance and healthy eating on a budget? What about the link between quality metrics and understanding nutrition labels? These are all related topics that providers and practices address every day! Care teams work 1:1 with patients to better manage their chronic diseases while at the same time, measuring and reporting outcomes that are related to payments and incentives. During this webinar, we will make the connection between patient engagement strategies and meeting quality metrics.  This webinar is designed for ALL AUDIENCES as everyone has a role in providing high-quality care- from the exam room to the boardroom. Prior to the webinar, we invite you to view this short video “Bites on a Budget” created by HMA Senior Associate, Brandin Bowden, MSc., as he attempts to build a healthy dinner for under $5. In this #HealthyDinnerChallenge, Brandin puts on his nutrition educator hat to share healthful tips to help your patients and clients navigate the grocery store, increase nutrient intake and promote comfort in the kitchen.

The Primary Care Behavioral Health (PCBH) Model of Integrated Care

The Primary Care Behavioral Health Consultation model (PCBH) is a psychological approach to population-based clinical health care that is simultaneously co-located, collaborative, and integrated within the primary care clinic. The goal of PCBH is to improve and promote overall health within the general population. This approach is important because approximately half of all patients in primary care present with psychiatric comorbidities, and 60% of psychiatric illness is treated in primary care. This webinar overs the framework of the PCBH model, the behavioral health consultant role, and a day-in-the-life look at integrated care using this model.

Perinatal Substance Use: Everything You Wanted to Know

Because many women and persons of childbearing age pregnant with SUD may not readily share information with providers and because pregnancy is a period where the motivation for change is extremely high, positioning providers to identify and care for this population has great potential for establishing a recovery path and changing lives. This webinar will review the risks and effects of SUD among women of childbearing age, pregnant and parenting persons and their affected infants, including screening and treatment considerations, breastfeeding decisions and ideal mechanisms for engagement and support of women and other pregnant persons on their recovery journey. We will also cover the short and long-term effects of SUD exposure on the infants, including non-pharmacologic alternative interventions and follow-up considerations.

Short Take: A Day in the Life of a Behavioral Health Consultant in Primary Care: PCBH Workflow

The Primary Care Behavioral Health Consultation model (PCBH) is a psychological approach to population-based clinical health care that is simultaneously co-located, collaborative, and integrated within the primary care clinic. The goal of PCBH is to improve and promote overall health within the general population. This short take is part of a series titled: A Day in the Life of a Behavioral Health Consultant (BHC) in Primary Care. Viewers will see example workflows for initial and follow up BHC visits including where referrals come from, the steps involved with BHC intervention and closing the loop with the primary care provider.
Integrated Care DC is managed by the DC Department of Health Care Finance (DHCF) in partnership with the DC Department of Behavioral Health (DBH). This project is supported by the U.S. Department of Health and Human Services (HHS). A total of $4,598,756, or 74 percent, of the project is financed with federal funds, and 1,639,167, or 26 percent, is funded by non-federal sources. The contents are those of the author(s) and do not necessarily represent the official views of, or an endorsement by, HHS or the U.S. Government.