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The Current Healthcare Environment: Key Information About Measurement, Outcomes, and Assessment for Practitioners (55 min.) LEARNING OBJECTIVES: 1. Identify ways in which the healthcare environment has changed. 2. Describe the key features of the triple aim. 3. Discuss the role population metrics and professional practice guidelines that drive the quality performance of behavioral health payers. 4. Define medical necessity. 5. Explain the role of outcomes, measurement, quality improvement and testing in population driven health care systems. ABSTRACT: The current health care environment is undergoing rapid change - the implementation of PPACA, the development of new delivery systems such as ACAs and patient homes provide both challenges and opportunities for practicing psychologists. At the broadest level these changes are designed to improve overall population health, experience of care and per capital cost of care referred to as the triple aim. This introductory-level presentation will review these broad goals and how changes in the health care environment impact both payers for care and providers of care. The performance of health plans and behavioral health payers is driven in part by population quality metrics that are vetted by organizations such as the National Committee for Quality Assurance (NCQA) and the National Quality Foundation (NQF) as well as metrics identified by governmental agencies such as CMS. It is important for practitioners to be aware of how these metrics are developed and used by payers. Population metrics are also influenced by professional practice guidelines. It is also important for practitioners to understand the concept of medical necessity and the role it plays in the management of behavioral health care. The implications of these issues for practicing clinicians are reviewed. BIOGRAPHY: Dr. Bruce Bobbitt is currently Sr. Vice President, Quality Management at Optum® Specialty Networks, UnitedHealth Group. In this position he is responsible for the Behavioral Solutions and Specialty Networks Quality Program that encompasses internal clinical operations and the quality of care delivered by network clinicians. Dr. Bobbitt has held a number of clinical and quality management positions at UnitedHealth over the past 20 years. Prior to coming to United he practiced psychology in Minnesota in numerous settings and has been a licensed psychologist in Minnesota for the past 31 years. In addition to publishing in the area, Dr. Bobbitt has given numerous presentations on the role of psychology in the health care system and is a Consulting Editor for Professional Psychology: Research and Practice. He served six years as the Minnesota representative to the APA Council of Representatives and was a member of the Minnesota Psychological Association Governing Council for 16 years. He received the Karl F. Heiser Presidential Award from APA in 1994 and the Susan T. Rydell Outstanding Contribution to Psychology Award from the Minnesota Psychological Association in 2014. He is currently a member of the National Committee for Quality Assurance (NCQA) Behavioral Health Measurement Advisory Panel. Dr. Bobbitt is a graduate of Cornell University and received his PhD in Child Psychology from the University of Minnesota. USER RATING: 4.5 out of 5 STARS (5) Buros Center for Testing is approved by the American Psychological Association (APA) and the National Association of School Psychologists (NASP) to sponsor continuing education for psychologists. Buros Center for Testing maintains responsibility for this program and its content. There is no known commercial support for this program. For a brief preview of this video, click link below.
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