Exploring the Epidemic of Untreated Pain: The Importance of Pain Management

Posted on April 9, 2012 by Kathleen Rand

Management of pain is crucial for providers

The Journal of Managed Care Medicine which is published by the National Association of Managed Care Physicians has consistently served as a trustworthy resource for industry providers. In the most recent publication, Volume 15, Number 1, JMCM once again proved itself both timely and reliable by featuring an article that explored the epidemic of untreated pain and the importance of pain management. The article discussed not only the high cost of ineffectively-controlled pain but the knowledge and abilities that pain-management clinicians need to possess to deliver effective care.

Adequate pain management calls for an inclusive evaluation and very often a multi-modality treatment strategy. Pain, chronic or untreated, can indicate high healthcare utilization and can produce significant societal costs. In fact, the total annual cost of poorly controlled persistent pain amounts to close to $100 billion per year. “Identifying healthcare issues which have a tendency to drive costs up over time, and impact the health of both patients and society is an important part of the financial management of healthcare. Because of its complexity, pain management requires a comprehensive approach to assessment and the use of validated tools and guidelines in order to optimize pain treatment methods, and benefit both the patient through superior care, and society through decreased costs,” stated Danyell Jones, a Senior Vice President with BHM.

Dr. Mark Rosenberg, President of BHM Healthcare Solutions and author of the recent article, has been focused on helping various providers and delivery systems to improve their methods of treating pain, while simultaneously ensuring that pain treatment options are viable from a financial perspective. Additionally, as a leader within the healthcare management consulting industry, Dr. Rosenberg has delivered several notable presentations and learning-series talks at national conventions dedicated to this topic. “Pain is costly on many levels, impacting the patient, managed care organizations, employers, and society in general. It is critical for providers to be unbiased in their assessments, to use and reference current evidence-based pain management standards and guidelines, and to advocate for each patient by collaborating with experts to formulate an interdisciplinary treatment plan,” commented Dr. Rosenberg. He continued, “An important strategy for healthcare management is to mitigate the cost associated with the loss in productivity resulting from persistent pain.”

To view the article “Untreated Pain Epidemic: Multi-Modality Approach to Pain Management” in its entirety, please visit http://issuu.com/namcp/docs/jmcm_15.1.

You Should Be Excited About This…..

Posted on March 15, 2012 by Danyell Jones

Have you ever wondered how you can improve your business in a down or rebounding economy?

Has your organization ever had the necessity for a crisis management strategy?

How are you dealing with adversity, and are you aware of the importance of engaging and expert to assist in growth?

I am excited to announce that we will be not only be having a guest poster in the upcoming week who will address these questions and more, but we are pleased and excited to have such a prestigious guest on our blog. Mr. Tom Bednarek will be offering invaluable advice this upcoming week on everything from business strategy, to how to handle a crisis situation, and how to best address the challenge of adversity. Our followers are welcome to submit comments and questions and will have live access to one of the nations leading healthcare executives…..so bring your questions and comments, we would love to hear from you!

Tom Bednarek is a Senior Consultant with BHM Healthcare Solutions and is responsible for providing key support for corporate strategy, operations and business development initiatives. Prior to joining BHM, Tom founded Beacon Acquisition Solutions to provide strategy M&A and business development advisory services to mid-market healthcare companies. Starting in 2008 Tom was named Chief Executive Officer of Premier Radiology and Affiliates, a regional provider of radiology services. While at the helm he initiated a successful turnaround of the organization and his initiatives eventually guided every component of the organization to profitability. In addition to these positions Mr. Bednarek was the Managing Director and Division President of Commercial Property and Investment Banking Services at Watermark Properties Group where his primary focus was healthcare mergers and acquisitions.

To schedule a one to one free initial consultation with one of BHMs leading healthcare consultants please email us at results@bhmpc.com or call us at 1-888-831-1171. BHM consultants provide real value and measurable results to healthcare firms, government agencies, and insurers through data driven and strategic management analysis, and assist organizations with Clinical Operations, Financial Management Improvement, Physician Advisor Services and Accreditation.

BHM Appoints New Business Division Leader Kathleen Schoenauer

Posted on January 30, 2012 by Danyell Jones

Congratulations Kathleen Schoenauer

BHM Healthcare Solutions is excited to announce the appointment of Kathleen Schoenauer, RN, BSN, CCM, to the position of Business Division Leader. Ms. Schoenauer brings a wealth of leadership and project management knowledge to the organization, as well as a strong reputation for successful implementation of state-of-the-art solutions within the fast-paced health care industry.

Prior to joining BHM, Ms. Schoenauer enjoyed an impressive 12 year career with APS. During that time, Ms. Schoenauer was responsible for the financial and business performance of multiple products and contracts to both a government and commercial customer base. Additionally, she has experience in designing and delivering services and solutions through collaboration with Medicaid agencies, state and local governments, health plans, employers and labor trust groups. Ms. Schoenauer has consistently exceeded expectations when improving profitability, designing a suite of services and building strong management teams.

BHM is very excited have Ms. Schoenauer join the organization, and looks forward to the benefit its customers will receive from her many years of experience in medical and behavioral managed care, specifically including her expertise in disease management, utilization management , and case management. “Because of her consistent ability to develop and market innovative approaches to process improvement and problem solving, we feel that she will prove to be a great asset to both our organization and our clients,” commented Mark Rosenberg, CEO of BHM.

Upon appointment to her new position, Ms. Schoenauer stated: “I look forward to my new role at BHM Healthcare Solutions and working with the talented team at BHM in providing best practice solutions for our partner clients. BHM Healthcare Solutions is a forward-thinking organization, positioned for growth and continued success helping clients achieve their goals and implement successful healthcare programs.”

NAMCP/AAMCN Survey Reveals Costs and Concerns of Primary Care Coordination

Posted on January 6, 2012 by Danyell Jones

The Journal of Managed Care Medicine which is published by the National Association of Managed Care Physicians has long been an outstanding resource for industry providers, and Vol. 14 No. 4, published in 2011 was no different featuring a timely article which focused on the integration of Behavioral Health into a Primary Care Setting. The article is focused upon a survey conducted by the National Association of Managed Care Physicians (NAMCP) in coordination with the American Association of Managed Care Nurses (AAMCN) which sought to determine how members of these organizations gauged the importance of Behavioral Health Care in the overall treatment of patients.

Click on the Graphic Above to Read this Article and More in the Current Issue

“As healthcare continues to change, and physicians become more and more aware of the mind-body approach to patient treatment, integration of Behavioral and Primary Healthcare will become preeminent in importance. At BHM Healthcare Solutions this is one of our guiding focuses when concentrating on assisting organizations with their clinical operations. We understand that the goal of every provider is the provision of superior care, but the financial aspect of Behavioral Health/Primary Care Integration was often cited as a stumbling block. The recent survey conducted by NAMCP is encouraging with the results showing that providers of care appreciate how costs can escalate when there is a behavioral health co-morbidity present with a primary health issue, underscoring the need for impactful coordination to not only ensure optimal care, but decrease overall healthcare costs” stated Danyell Jones.

Dr. Mark Rosenberg, President of BHM Healthcare Solutions and author of the recent article has often assisted organizations guiding them toward an integrated approach to healthcare. Additionally, Dr. Rosenberg has delivered several notable presentations and learning series around the country at national conventions focused on this topic. “Behavioral Health integration is one of the most substantial things an organization can do to ensure quality improvement in healthcare ” states Dr. Rosenberg, who went on to say that “one of the most important aspects of behavioral health consulting is ensuring that integration becomes part of every organizations healthcare management strategies.”

For more information on BHM Healthcare Solutions services please visit our quality improvement page

Join BHM Experts at NC Council 2011 Conference

Posted on November 21, 2011 by Danyell Jones

BHM Healthcare Solution will be exhibiting at the upcoming NC Council of Community Providers Conference December 5-7, 2011. This exciting conference will be bringing together NC members and will be providing programs with a strong, cohesive, statewide voice through policy analysis, technical assistance, and educational programs. Among these programs BHM will be hosting a dynamic learning series entitled: “Critical Access Behavioral Health Agencies: How to Survive and Prosper in a Time of Transition.”

BHM Healthcare Solutions (BHM) is pleased to be hosting a dynamic learning session at this year’s NC Council of Community Providers 2011 Conference. The conference will be held on Dec. 5^th through the 7^th, 2010 at the Pinehurst Resort. For more information, including registration information please visit: http://www.bhmpc.com/nc1 .

The Conference is given each year as part of the NC Councils programs of ongoing educational and technical assistance program. The central mission of the conference is to provide training resources that respond to the diverse needs of both public and private mental health providers, and allowing them the opportunity to share and learn about the latest programmatic and management innovations.

As part of the conference expert consultants from BHM will be hosting a dynamic learning session based on the Harvard Business School Case Study Method. This session entitled “Critical Access Behavioral Health Agencies: How to Survive and Prosper in a Time of Transition” is a participant centered learning series. Rather than the traditional lecture series, this opportunity will allow attendees to place themselves in the role of key decision makers as they review real cases, identify problems, and arrive at a set of recommendations while being guided by an expert panel which is familiar with CABHAs and the operational challenges that they face.

The Case Study Method is a “profound educational innovation that presents the greatest challenges confronting leading companies.” Cases which present a wide array of issues are presented, and through the process of dynamic exchange attendees will become “adept at analyzing issues, exercising judgment, and making difficult decision. The session will further add value for attendees by allowing participants to submit their own case studies which highlight areas of concern that they are facing within their own organization, and open this up to the panel for discussion. Topics which will be explored include the complexity of CABHA rules and regulations, operating a CABHA in the new Managed Care Medicaid Waiver environment, how to maximize revenue, how to mitigate fraud, abuse, and compliance risk, and how to incentivize productivity.

Leading the roundtable of experts is BHM Healthcare Solutions President Mark Rosenberg. Other experts will include Jennifer Huber-Ternay, CFO, BHM; Brian Johnson; SVP of Finance and Claims, BHM, and Ann Wilson, Senior Consultant, BHM.

For additional information about the Conference please visit: http://www.nc-council.org/wp-content/uploads//2011/09/2011ExhibitorDescriptions.pdf

Meet Another Member of BHM Staff!

Posted on November 18, 2011 by Kathleen Rand

In this blog, we will provide a brief introduction to another member of the BHM consulting team:

Brian Johnson, Senior Vice President of Finance and Claims Operations at BHM, brings a wealth of financial management knowledge with his 14 years of executive level experience in the healthcare field to his presentations. Mr. Johnson is known for his expertise in financial analysis, budgeting, claims authorization, credentialing, and pharmacy workflows and processes. His straightforward style and undeniable grasp of how to guide an organization to be more profitable and productive will be a valuable addition to any speaking engagement.

Take a look at this youtube video featuring Brian Johnson:

BHM helps their clients more effectively manage medical costs and improve operational efficiency as well as assist with startup of new programs. The BHM team of expert healthcare operational consultants works with organizations to optimize healthcare strategic management. Additionally, given that quality improvement is mandatory for the survival of any health care organization, BHM’s extensive experience in the healthcare industry can assist any organization in optimizing and managing a Quality Improvement Program, improving the standard of care, meeting accreditation and regulatory requirements, and increasing productivity.

BHM has been successful with program design and implementation, enables clients to utilize customized clinical treatment programs as well as clinical management programs. A successful program begins with an evaluation of the statistics and results in a project plan that is developed to meet required timelines and objectives. Results from BHM’s assessment are compared to industry statistics, and recommendations are documented in a detailed report format. Further, BHM engages in a discussion pertaining to its comprehensive recommendations and will provide on-site or telephonic oversight of suggested implementations to ensure that an organization reaches its full potential.

Don’t Miss These Exciting Events!

Posted on November 12, 2011 by Danyell Jones

Hello,

We are please to present a number of exciting Blog events this November.

Be sure to check out Kathleen Rands “Meet the Staff” series where overviews of BHMs consultants will be highlighted including videos of our experts, biographical information, and a more in depth focus on some of the services the BHM Healthcare Solutions provides. Kathleen kicked this series off with a feature of our President, Mark Rosenberg.

Following this Vickie Axsom-Brown, one of BHMs newest members will host an online learning series beginning Nov. 15th centered on RAC audits. As a former auditor and wide known industry expert Vickie will share secrets and tips on all things RAC related. Additionally she will be welcoming comments and questions, and this is a rare opportunity for our followers to gain valuable insight, and get questions answered directly by someone with substantial experience in the field.

We hope that you will join us for both of these dynamic sessions, and we look forward to seeing all of your questions and comments!

Best Regards,

Danyell Jones

BHM Healthcare Solutions Pursues URAC Independent Review Organization Accreditation

Posted on October 24, 2011 by Danyell Jones

BHM Seeks IRO Accreditation

BHM Healthcare Solutions, a nationally recognized healthcare consulting firm, is pleased to announce that they have begun to work toward URAC Independent Review Organization (IRO) Accreditation. As a consulting firm which provides a variety of services, BHM understands that it can best meet the needs of its clients, as well as strive towards ensuring that their program meets nationally recognized standards by pursuing accreditation.

BHM Healthcare Solutions is pleased to announce that they are pursuing URAC IRO Accreditation in order to establish that they meet nationally recognized standards and the goals set forth pertaining to:

Decreasing the risk of conflict of interest
Ensuring access to actively practicing expert physicians
Adhering to demanding state and federal specific review timeframes
Meeting requirements for state specific physician licensure review
Ensuring that ongoing quality improvement is taking place regarding network provider patient safety events
Ensuring that there are no issues regarding potential billing non-adherence; and
Ongoing analysis of proposed treatment to current scientific literature, FDA approved treatment and evidence based guidelines

“BHM has long strived to provide superior customer services, products, and solutions for our clients. Pursuing URAC IRO Accreditation is one more step toward adhering to the highest quality standards available for Independent Review Organizations, and we are pleased to have the opportunity to work toward achieving URAC Accreditation,” stated Danyell Jones, Director of Customer Solutions at BHM.

According to URAC, “URAC’s Independent Review Organization (IRO) standards assure that organizations that perform this service are free from conflicts of interest, establish qualifications for physician reviewers, address medical necessity and experimental treatment issues, have reasonable time periods for standard and expedited reviews, and appeals process. An organization with this URAC accreditation strives for a fair and impartial review process that is of benefit to both patients and physicians with grievances.”

URAC, an independent, nonprofit organization, is a leader in promoting health care quality through accreditation, achievement, and certification programs. URACs standards keep pace with the rapid changes in the health care system, and provide a mark of distinction for health care organizations to demonstrate their commitment to quality and accountability. BHMs CEO, Mark Rosenberg has stated that “we are very excited as an organization to begin to work toward URAC IRO Accreditation, as healthcare consultants we understand the importance of URAC Accreditation and what it means to an organization in terms of achieving national recognition. We look forward to the process of preparing for Accreditation, and are excited as a team to be participating the URAC process.”

BHM Featured at NC TIDE Conference

Posted on October 3, 2011 by Danyell Jones

BHM Healthcare Solutions, commonly recognized as one of the nation’s best behavioral health consulting firms, is proud to announce

Join BHM in Asheville NC for the NC TIDE Fall 2011 Conference

that two organizational members will be featured speakers at the upcoming NC TIDE Conference in Asheville, NC occurring November 13^th through the 16^th 2011. NC TIDE, which stands for training, instruction, development, and education, is a bi-annual conference that includes staff from all aspects of the Mental Health, Developmental Disabilities, and Substance Abuse Services field. This year’s fall conference will be held in Asheville, NC and is expected to draw more than 400 participants from LMEs, provider organizations, and state offices. NC TIDE hopes to provide information that the Sate, LMEs and providers need to improve performance in all areas and at all levels.

As part of the NC TIDE Conference BHMs Senior Vice President of Finance and Claims, Brian Johnson, will be hosting a session entitled “Using Financial Data for Making Management Decisions.” This talk is targeted at those who wish to learn more about the financial management of healthcare. Attendees will learn why financial data is important, how to utilize trend analysis, and gain a comprehensive understanding of the different IBNR models and how to utilize them to make impactful decisions.

Joining Mr. Johnson will be Connie Coburn-Smith, a senior consultant with BHM and URAC accreditation specialist. Mrs. Coburn-Smith will be hosting two talks, the first of which is entitled “Performance and Progress: the Basics of CMS Quality Framework.” This session will be focused on quality improvement for healthcare and attendees will learn about the CMS Quality Framework and why it is important for their organizations. Building on this talk, a second presentation will be made entitled “Quality Improvement Projects: Keys to Success.” This quality improvement focused presentation will instruct attendees on how to effectively target quality improvement gaps and make the necessary changes.

BHM Healthcare Solutions is extremely pleased and honored to be featured presenters at this falls NC TIDE Conference and would like to encourage anyone to attend by registering at http://www.nctide.org/

To learn more about select BHM Quality Improvement programs, initiatives and trainings please visit http://www.bhmpc.com/quality-improvement/

BHM Healthcare Solutions Pursues URAC PCHCH Auditor Certification

Posted on September 21, 2011 by Danyell Jones

In July BHM Healthcare Solutions was recognized as one of four “first adopting” organizations who have already began working toward URAC PCHCH Auditor Certification. There has recently been a new approach in the marketplace for medical home recognition with the launch of URACs Patient Centered Health Care Home Programs. The URAC PCHCH Program was developed to educate and guide health care practices, and/or their sponsoring health plans, insurers, and pilot programs, as they transform into truly patient-centered health care homes. With the recent release of URAC PCHCH Practice Achievement, the demand for URAC PCHCH Auditors has grown. In July BHM Healthcare Solutions was one of four firms which were identified as “working toward URAC PCHCH Auditor Certification.”

According to URAC, the URAC PCHCH Auditor Certification is “an extension of URAC’s overall PCHCH program which will meet the needs of those entities whose responsibility will lie in independent auditing of health care home practices to determine their degree of successful achievement of the PCHCH program standards. The PCHCH Auditor Certification verifies that an organization can perform independent audits on practices against URAC’s PCHCH Practice Standards.”

Organizations who successfully meet the requirements to be PCHCH auditors will be allowed to independently audit health care practices to determine if they meet the URAC PCHCH Standards. In order to receive PCHCH Auditor Certification, an organization must first show that they themselves meet URACs stringent standards in relation to operations, training, processes, and systems. In addition, the organization must meet additional business requirements, attend specialized auditor training, and pass validation requirements. The organization must also meet all applicable HIPAA business associate requirements, and successfully undergo an evaluation in which they are tested on their understanding of the URAC PCHCH Standards.

URAC, an independent, nonprofit organization, is a leader in promoting health care quality through accreditation, achievement, and certification programs. URACs standards keep pace with the rapid changes in the health care system, and provide a mark of distinction for health care organizations to demonstrate their commitment to quality and accountability. BHMs CEO, Mark Rosenberg has stated that “we are very excited as an organization to begin to work toward URAC PCHCH Auditor Certification, as healthcare consultants we understand the importance of URAC Certification and what it means to an organization in terms of achieving national recognition. We look forward to the process of preparing for Certification, and are excited as a team to be participating the URAC process.”