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New Regulations Lead to Innovation in Behavioral Health

As a business consultant with InfoWorks, one of my favorites aspects of my job is watching the evolution of our engagement with clients over the course of several years. We have had the pleasure of working with a behavioral health company, nationally recognized as a pioneer in serving individuals with intellectual and developmental disabilities, behavioral health diagnoses, and complex physical and medical conditions. This client was facing a situation where regulations were changing and CMS was interested in using the client’s solutions in a broader way. They turned to us to conduct a market assessment, evaluate their ability to take advantage of the business opportunity at hand and determine the most appropriate business model and path forward.

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As part of the market assessment, we evaluated the market opportunity, assessed the competitive landscape with potential threats and developed a compelling products-services vision along with three business models for taking that vision to market. This analysis enabled our client’s leadership to maintain independence and control of their solution while taking advantage of new opportunities.

Following the assessment, our client decided to move forward with implementing the products and services vision, which included developing a configurable, web-based solution to handle any type of product needs across all current and future clients. Before beginning design of the new solution, we first worked with the client to document current business processes and create requirements to serve as the road map for this configurable product. These requirements included the following:asset-3

  • An assessment with an automated algorithm for determining outcomes
  • A complicated clinical review process
  • A security role-based matrix
  • Defined assessment, non-assessment, and administrative configurations

The client provides specialized assessments to improve quality of life, manages complex programs that serve vulnerable populations and provides states with speed, accuracy, and access to the data needed to inform policy and program decisions and improve the delivery of healthcare.

Given the complexity of the requirements and tight timeline, our client needed a partner with a dedicated team of agile project management, business analysis and development team to design and develop this product, including the first assessment. Our team designed a sophisticated architecture that could handle complex clinical review and escalation processes to manage and maintain a high degree of quality of outcomes, specifically 1,598 different possibilities for just that one assessment, while maintaining stringent security and privacy controls. Prior to this new platform, this client serviced multiple clients with one or more contracts that were managed in separate software packages, managed locally. This approach resulted in longer implementation timelines, higher complexity, and more resource-intensive maintenance for the organization to maintain independent systems, despite sharing the same core functionality.

asset-2We were able to migrate one state to the new product this past summer. While we had estimates of volume and number of users, the acceptance and activity of the new system exceeded our client’s expectations for both the volume of assessments conducted and the operational efficiencies achieved. Over 5,400 assessments were completed in the first week by users with 2,300 unique logins. Our client also shared that the implementation of this product resulted in an 88% increase in productivity for their staff, which includes clinical reviewers, quality reviewers, and support staff. As they on-board additional clients, the benefits of having a single configurable system for maintenance, training, and support will accelerate.

The state’s officer responsible for this program considered this launch “making history”, as they had not changed their approach in 30 years.

Our engagement with this client continues as we are adding assessments to the platform and preparing to on-board new clients, increasingly allowing the same number of clinicians to serve more contracts while maintaining the same level of quality. It has been exciting to participate in the execution of the collective vision and see the tangible benefits of this multi-year effort. Being able to bring value to our clients through creativity and innovation is so rewarding.

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For more information, contact Kristin Bollinger at kristin.bollinger@infoworks-tn.com.