Report to the Operations

1

• Report to the Operations
• Sub-Committee
• September 8, 2006

2
Network Operations
3
Network Operations/Status August 2006

• 1,495 Total Individual Providers
• Increase of 39 Providers since July 2006
• (Count includes referring providers within
  groups)
• 1,046 Facilities
• Increase of 10 Facilities since July 2006
• (Aggregate of each location by Type and Specialty
  not including groups)

4
Web Registration
5
Web Registration, contd

• Provider Forums Web Registration Trainings
• Total RSVPs 317
• 8/18 - Rocky Hill/ASO Office
• 8/22 - New London/Mitchell College
• 8/24 - Wallingford/CHA
• 8/28 - Bridgeport
• 8/30 - Wallingford/CHA
• 9/6 - Rocky Hill / ASO Office
• Security Access/User ID Requests
• 1058 User Ids generated as of 8/29/06
• 480 Requests currently in process

6
Web Registration, contd

• Security Update
• Effective August 31, 2006 at 530pm
• Upgrade to provide additional layer of security
• Provider Authorization look up capacity in place
• 5,137 Registrations completed since August 1st
• Improvement in time to complete noted (average _at_
  4 minutes)
• Winfax Registration Forms
• Individual Practitioners without computer and/or
  web access
• 34 Requests as of September 1, 2006

7
Utilization Management
8
Members who Access Service by LOCAugust 2006
ADR/IPD Inpatient detox/rehabilitation EDT
Extended Day Treatment GHA/GHC Group home
1.0/2.0 IOP Intensive outpatient
IPF Inpatient Psychiatric Facility PHP Partial
Hospital Program PRTF Psychiatric Residential Tx
Facility RTC Residential Treatment Facility
9
Discharge Delay Status

• 21 of children in an Acute Inpatient setting are
  defined as Discharge Delay
• 50 are awaiting placement in Residential and/or
  PRTF
• is 44 days
• 15 are awaiting Foster Care placement
• 15 are awaiting Group Home placement
• Average length of stay in Delayed status
• Discharge Delay from resi currently being
  scrubbed for accuracy
• Care Management training continues
• Inter rater reliability to be tested

10
Valid Reasons For Delay In Discharge From
Hospital Or Residential Care
11
Authorization and Concurrent Review Update
12
ED Delay Tracking August 2006
13
ED Delayed Discharge Activity

• Flow charts being developed with DCF
• All EDs being contacted daily
• No unanticipated notifications in August,
  resulting in increased case identification and
  improved discharge planning, supported by
  seasonal reduction in need for acute service
• Overview
• May 6 cases, average LOS 3.5 days
• June 5 cases, average LOS 7.2 days (1 outlier)
• July 10 cases, average LOS 2.9 days
• August 11 cases, average LOS 1.1 days

14
ICM Referral Tracking
15
ICM Activity

• All delayed status members currently in
  inpatient settings are assigned
• CCRs increased to each week, vs. every other
  week to assist in discharge planning
• Beginning to attend MSS mtgs with System
  Managers
• Sharing daily census reports in MSS mtgs to
  review delayed members AND all others in 24 hour
  care to assist in discharge planning

16
2006 Call Volume YTD
17
Calls answered in lt 30 seconds YTD
18
CT BHP CALL MANAGEMENTIncoming Calls Totals
August, 2006

• Total 4872

19
Types of Service Connect InquiriesAugust, 2006

• 46 - Provider Referrals for Members
• 18 - Member Eligibility Verification
• 19 - Provider Related/Authorization/Enrollment/
  Billing
• 17 - General Information
• 63 Member Inquiries (highest percentage to
  date)
• 0.01 Inquiries initiated due to provider
  status change from IN to OON

20
Quality Management
21
Clinical Studies

• Child study Ambulatory Follow-up within 30 days
  of inpatient discharge from a hospital or RTC.
• Adult study Interface with CT BHP and the MCOs
  regarding Intensive Care Management.
• data collection re. co-morbidity
• Identification of trends in diagnosis
• timeliness of CT BHP response for co-management
• type of response
• member satisfaction

22
Complaints January August 2006
23
Grievances
24
Community InteractionPeer/Family
Services
25
Peer/Family ServicesAugust 2006

• Held first CT BHP ASO Consumer Advisory Committee
• 37 Community meetings attended
• (i.e., School, PPT, MSS, Collaborative,
  Court, DCF,
• Riverview meetings)
• 15 Home Visits conducted
• 38 Open Consultations
• 13 Closed Consultations
• Final interviews complete to fill remaining
  positions