Health Plan Technical Assistance

AHP leverages its experience in behavioral and primary health systems to help organizations navigate the shifting regulatory, financial, clinical, and technological demands of the health care environment.

AHP’s approach to implementing evidence-based practices is founded on an understanding of the consequences experienced by individuals and families affected by the opioid epidemic. The group works with health plans, including managed care plans, to empower communities to develop initiatives and redesign systems of care that prevent initiation of use, reduce harm, and halt the loss of life due to opioid use. AHP’s targeted opioid interventions take shape after a comprehensive needs assessment that includes data/document review, situational analysis, and readiness-for-change assessment.

AHP understands that the consequences experienced by individuals and families affected by the opioid epidemic reverberate at the community level, and the organization believes that sustainable solutions are rooted in the same place.

The firm’s industry network provides clients with the connections that can be useful in planning for and adapting to regulatory change, technical innovation, and new markets.

BluePath Health worked with CHCF to inventory and describe health plan and provider-based tools for aiding safe prescribing. The assessment outlined a continuum of offerings including ECHO-based provider education, electronic consults with integrated pain management clinics, community-based case management, mobile applications, and grassroots community coalitions. The firm supports multiple health plan and provider-led strategies to provide access to pain management specialties through various telehealth implementations.

BluePath Health understands the impact that leading organizations are making to curb the misuse of opioids, and desires to be part of efforts to ensure that best practices are learned and disseminated as quickly as possible. The firm seeks to encourage stakeholders to collaborate and seek solutions that may not be achievable alone.

At the executive level, the firm works to deliver positive results for quality, safety, and performance improvement efforts, with the aim of meeting and exceeding internal and external stakeholder expectations. The team has demonstrated its ability to apply continuous improvement and patient safety science.

It offers consultative services to executive leadership and managers within organizations for quality improvement, health and safety, credentialing, accreditation, and regulatory compliance.

CFCB aims to effectively matrix consultants and experts committed to ensuring that all health plans and health systems launch organization-wide opioid initiatives with the goal of driving down opioid-related morbidity and mortality in California.

The firm supports health plan and delivery system opioid initiatives by assessing the current state of efforts to fight the epidemic, developing and implementing key recommendations that reflect widely accepted and evidence-based interventions, and carrying out ongoing coaching and evaluation of progress toward goals.

Cristobal Consulting partners with a team of consultants to support health plans and delivery systems as they implement opioid initiatives. The firm has partnered with CHCF in its efforts to address the opioid epidemic since 2015. Kristene Cristobal helped design and facilitate a key meeting with statewide clinician and program leaders that kicked off several opioid initiatives. She was also project manager and quality improvement faculty for CHCF’s Residency Action Group, and served as an improvement coach to 16 coalitions in the California Opioid Safety Coalitions Network.

Cristobal Consulting’s team members have experience supporting both Medi-Cal and commercial health plans, including Partnership HealthPlan, Inland Empire Health Plan, San Francisco Health Plan, and Kaiser Permanente.

EM Consulting works exclusively in and with safety-net health care systems, including community clinics, Medi-Cal and Medicare health plans, county behavioral health and medical services, and foundations and institutions focused on health equity. Elizabeth Morrison, principle consultant, and her multidisciplinary team have a strength-based philosophy that informs their approach to organizational consultation. The core principle of facilitating, supporting, and elevating the human connection in health care provision is central to EM Consulting’s strategy and practices.

The team has worked with health plans in California to develop and implement large, multi-site medication-assisted treatment and complex care initiatives, as well as to integrate the administration of the behavioral health benefit into health plan operations. EM Consulting has provided individualized motivational interviewing Train the Trainer programs to Federally Qualified Health Centers and other health providers, and has partnered with the Institute for Healthcare Communication to create an interactive workshop titled “The Empathy Effect: Mitigating Bias to Improve Health Care Outcomes,” which is conducted in the US and Canada.

Freed Associates works to understand the client’s culture, policies, practices, and technology, leading to a definition of scope, tasks, measurements, success factors, and required outcomes. The firm believes that technology and practice need to be married for long-term success. Freed collaborates with its clients to design a program and implementation that fits the organization with a focus on maximizing benefits and impacting lives.

Freed’s engagements range from program management to data analytics, and from implementations with a change management focus to process redesigns that target unique requirements and environments.

Harbage Consulting’s team would use a personalized and collaborative approach to assisting health plans in conducting gap analyses, identifying priorities, and implementing strategies to support the establishment of enhanced opioid safety initiatives across the delivery system. Its behavioral health team offers perspectives and insights into the state’s priorities and an understanding of the successes and challenges that have been experienced to date. Harbage Consulting seeks to support California’s health plans in addressing the opioid crisis.

The firm has worked with health plans in the identification and implementation of new programmatic structures, which have included:

• Development of toolkits and resource guides to support operational changes
• Provision of technical assistance
• Assessment of current state activities and identification of actions
• Implementation of action plans that address programmatic and regulatory changes

In 2017, CHCF engaged HMA to develop two opioid white papers. The first outlined opioid safe prescribing best practices for curing overuse of opioids. The second paper focused on medication-assisted treatment, advocating for commercial and Medi-Cal access to treatment and addiction services.

Manatt works with major health plans across the country as a legal advisor, management consultant, and policy expert. The firm has particular expertise in assisting plans in working with their providers to improve outcomes and reduce the cost of care. This experience means the organization is equipped to provide in-depth support in implementing opioid intervention change campaigns, centering on the question of how plans can support behavior change in their provider network.

Manatt has also published extensively on the opioid epidemic, keeping it up to date on the clinical, regulatory, and policy dimensions of the issue. The team also has a significant data analysis capacity that it can use to glean valuable insights from claims data to help guide decision-making.

The firm has developed online training in the form of CME activities that have reached 387,000 learners for programs sponsored by the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse, and the National Center for Complementary and Integrative Health, the complementary medicine institute at the National Institutes of Health.

To develop CME, Medscape will hire faculty subject matter experts, develop manuscripts, arrange filming in the case of multimedia courses, accredit the activity using its in-house accreditation staff, host and promote the activity on its site, and provide CME activity participation metrics to health plans.

North Highland/eTransX partner with health plans in setting the vision and design for their strategies for opioid safety. They are technical and implementation partners through all stages of planning and execution: assessment, proof of concept, piloting, launch, and adoption.

The team’s services center on three pillars. First, through strategic health care thought partnership and execution partnership, the two organizations bring expertise and diverse experience to support clients. Second, eTransX’s OCC platform is a technology solution that integrates health information from disparate systems to coordinate information across all entities in a care community. Third, the team offers change management assistance to help organizations adopt new processes and accelerate program progress.

Together, the team offers a human-centered approach based on expertise and diverse experience.

WI’s trainings and tools help practices address enormous challenges in managing chronic pain and opioid addiction. This comprehensive intervention includes supportive tools, strategies, and services for primary care providers and patients on the front line of the crisis. The intervention helps increase primary care providers’ skills and confidence to provide guideline-informed preventive care and encourages non-pharmacological treatment of pain and responsible opioid prescribing, with the downstream effect of reducing opioid addiction and dependence.

WI has provided this intervention to practices around the country in 28 states; Washington, DC; and Puerto Rico. It has implemented statewide programs in Colorado, Maine, and New Jersey. Post-participation results indicate improved provider knowledge and confidence, increased adoption of risk mitigation tools, reduced reliance on opioids, and increased access to treatment for opioid addiction.

The intervention is based on Centers for Disease Control and Prevention guidelines, with a strong emphasis on opioid-sparing strategies, integration of behavioral health and medical care, and expansion of access to medication-assisted treatment.

WI offers training and technical assistance in a variety of formats including: on-site training, case-based distance learning with Pain & Buprenorphine/MAT Project ECHO, virtual access to pain specialty consultation via eConsultations, comprehensive round-the-clock resources for treating pain and transforming care via PainNET, and collaborative learning.