CLINICAL OPERATIONS FOR HEALTHCARE DELIVERY
PROGRAM DEVELOPMENT
We have been successful with program design and implementation. Our experience enables us to understand the position and duty of each stakeholder. This allows us to help design or develop both clinical treatment programs as well as clinical management programs.
BHM delivers widespread clinical and executive knowledge to each program. A successful program begins with an evaluation of the statistics, which is necessary to assess services and outcomes of the program. A project plan is then developed to meet required timelines and objectives. We then monitor the developing program to identify process improvements.
Examples of services
- Inpatient units
- Substance abuse programs
- Sub acute programming
- Day Treatment
- IOP Crisis Services
- Denial Management Programs
- Inpatient Treatment Programs
- Inpatient Management Strategies
In order to improve your operations, we will complete a comprehensive assessment and study key characteristics of your behavioral health organization.
FEATURES
- Results from assessment are compared to industry statistics and recommendations are made and documented in detailed report format.
- We engage in a discussion of the comprehensive evaluation to guide our client to a complete and comprehensive understanding of our findings.
- We provide on-site or telephonic oversight of suggested implementations to ensure that your organization reaches its full potential.
BENEFITS
- Refocus of your organization's operations and services
- Improved effectiveness
- Enhanced productivity
- Superior level of care provided
- Your organization is compensated for services rendered
- Reduction in less than optimal patient care
- System inefficiencies are reduced
- Streamlining of care coordination
CLINICAL OPERATIONS FOR PAYERS
UTILIZATION MANAGEMENT
BHM’s integrated healthcare strategies consist of organized processes that apply proven methodology to guarantee quality of care and cost containment within your organization. We believe that managing the quality of care within budget is important. BHM’s healthcare utilization management programs ensure the delivery of high quality cost efficient health care for your organization's members. At BHM we are able to provide a variety of services which will help you to meet these objectives including:
- Utilization Review/Management
- Psychiatric Peer Review
- Prospective Review
- Concurrent Review
- Streamlining of care coordination/ discharge planning
- Only appropriate patient care services are delivered
- Services are provided in the most appropriate setting
- Access to experienced utilization review professionals
- Reduction of over utilization
- Development of Key provider group / “self-managed” provider strategy
- Evaluation of quality of care to determine its contribution to the improvement of health and well being
- Containment of Medical Cost
FEATURES
- Efficient utilization of facilities and services through ongoing monitoring and education
- Evaluating the necessity, appropriateness and efficiency of health care services against established guidelines and criteria
- Evaluation of the necessity, appropriateness and efficiency of the use of health care services, procedures and facilities
- Includes actions and decisions that are based on data analysis
- Effectively manage and contain medical costs
- Enables coordination between patients and providers, as well as communication between providers and insurers
- Patient channeling to preferred providers
- Compliant with URAC standards
BENEFITS OF BEHAVIORAL HEALTH STRATEGIES
- Only appropriate patient care services are delivered
- Services are provided in the most appropriate setting
- Less than optimal patient care outcomes are reduced
- System inefficiencies are reduced
- Access to experienced utilization review professionals
- Reduction of over utilization
- Streamlining of care coordination
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