BHM Appoints New Business Division Leader Kathleen Schoenauer
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
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.
“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
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. 5th through the 7th, 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!
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!
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
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
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 13th through the 16th 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
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.”
BHM Healthcare Solutions has Unprecedented Success with North Carolina Waiver
BHM has NC Waiver Success
On April 1st, 2011 the state of North Carolina Department of Health and Human Services in association with DHHS released a request for applications for 1915 b/c Medicaid Waiver Expansion. The time frame for submission was tight, and the requirements stringent, causing many Local Management Entities to seek outside help from healthcare consulting firms. “The submission process for LMEs was certainly complex and time intensive,” stated Mark Rosenberg, CEO of BHM Healthcare Solutions, “but recognizing the individual strengths of each LME and how they could be applied as positive attributes which met the requirements of the NC Medicaid Waiver is where our organization was able to excel.” In the end the North Carolina Department of Health and Human Services along with DHHS chose four LMEs for selection who exhibited that they met all regulatory and technical criteria, as well as industry standards for the administrative, clinical and financial operations of a Pre-paid Inpatient Health Plan (PIHP). Three of the four LMEs selected worked with BHM Healthcare Solutions throughout the application process, and all organizations who worked with BHM on the RFA Submission were chosen.
“To have a 100% success rate for application acceptance with every client that BHM assisted was phenomenal, and unprecedented from a healthcare management consulting firm standpoint” stated Danyell Jones, Director of Customer Solutions at BHM, who went on to say that “It is rare to be able to participate in a statewide initiative and experience such a clearly delineated success with 75% of the total chosen applicants receiving assistance from BHM. We believe that all of the organizations that we worked with were excellent candidates for participation in the Waiver program. Each of them had unique individual structure, goal, and set of strengths. It is to these organizations that we give credit for successful Waiver inclusion, but it is the great honor of BHM to have been able to work with so many exceptional groups and highlight their attributes in a way which assisted them in being chosen to participate in the Waiver initiative.”
As stated, BHM credits the individual organizations that it assisted with Waiver inclusion, but also feels that it is a testament to the consulting firm that it was able to work with many different groups on a large and difficult project and get positive results for each and every one of the clients served. Much of our internal credit should be given to BHM project leads Jennifer Terney, and Connie Smith. “Jennifer, who understands all aspects of MCO operations is an expert when it comes to healthcare financial management, and Connie, who also understands all aspects of MCO operations, specializes in quality improvement, both deserve special recognition in their involvement in this project,” stated Mark Rosenberg, “they really led the efforts of BHM staff members and shaped the unique approach that assisted our clients with successful submission.”
To see other examples of what BHM Healthcare Solutions has achieved for their clientele please visit the BHMs Case Studies Page at: http://www.bhmpc.com/case-studies/
BHM Launches Physician Peer Review Portal
BHM Healthcare Solutions, a nationwide consulting firm, has long been recognized for their expertise in providing physician advisor
BHM Launches PA Portal for Clients
services to their client base. The firm was built on a strong foundation of providing quality physician advisory services, which go beyond the typical quantitative review services and offer a qualitative experience through the utilization of in-depth guidance and ongoing improvement strategies. Now BHM has taken this process one step further with the development and launch of a new PA Portal which will drive efficiency, and accessibility. Brian Johnson, Chief Technology Officer at BHM was instrumental in driving the development of this new product and recently stated that “It has been our goal in designing this product to make the peer review process more streamlined, which will translate into better accessibility, affordability, and ease of use for client organizations and our physicians.”
The PA Portal, which was officially launched in August 2011, is a scalable solution for peer reviews. The product has undergone testing and has been found to have the capacity to meet larger volume demands while simultaneously increasing speed and decreasing manual duplication which can be problematic for organizations participation in the physician peer review process. This new tool will be used in tandem with BHMs unique physician advisor approach which incorporates expertise, training, and education allowing for the provision of exceptional review services that provide clinical leadership modeling opportunities for client organizations. All of this is backed by a broad base of physician advisors who are able to conduct utilization management review, complex file reviews, appeal reviews, and provide physician advisor consultations. Mark Rosenberg, President and CEO of BHM has stated that “PA services are the foundation that our consulting firm was built upon, and many of our associates have more than 15 years experience providing PA services to hospitals and managed care organizations.”
BHM looks toward the future of providing superior physician consulting services which bring value, innovation, and cutting edge technology to our clients and the PA Portal is a giant advancement to that end. Annette Marie, Director of Administrative Operations at BHM, was another member of BHMs highly trained team who was pivotal in the development and creation process of the PA Portal. Ms. Marie has stated that “BHM is exceptionally pleased to bring this new product to our existing and future clients. The PA Portal is a secure, automated, and efficient solution to meeting physician advisor needs in a standardized way which will provide the benefit of faster turn-around times, lower cost, and improved documentation.”
To learn more about BHM Healthcare Solutions and their full range of innovative products and services related to physician advisor services please visit: http://www.bhmpc.com/physician-advisor/