Last Updated on October 14, 2023
Commonwealth Coordinated Care Pus or CCC Plus is a statewide Medicaid managed care program implemented in August 2017. Under this program, each person who meets the criteria will be assigned a Care Coordinator. These care coordinators appear to have a similar role as current case managers who serve these individuals in public agencies like community service boards. This situation has many case managers concerned that they will be eventually replaced by these private companies.
There is good reason to be concerned about these recent
changes. For many public agencies, the revenue generated through case
management billing not only funds case manager salaries but they also fund
other programs within the agency that don’t bring in enough revenue. Here are
the key areas of concern that have public case managers a little nervous.
Competition- Care
coordinators seem to have the same basic functions
as case managers. Some have even started
to sit in on annual meetings
with case managers. Case managers still
coordinate the majority of the support services at this time. However, this
could change in the future as case managers are starting to transition to these
private Managed Care Organizations. This could eventually
threaten job security in public agencies.
Loss of Good Employees-
Case managers have already started to transition into positions as Care
Coordinators with private managed care companies. Many of these case managers
have years of experience in the areas of mental health and intellectual
disability. This experience is valuable due to the constant changes in
regulations. Intellectual disability services in particular seem to get more complicated
every year. The loss of talent and
experience can set agencies back due to constant hiring and retraining of new
staff.
Do People Need Two
Case Managers? – Another concern is a potential duplication of services.
Service roles are not clearly defined which leads to both care coordinators and
case managers essentially providing overlapping services. The concern is that Medicaid
will eventually choose one over the other to coordinate services. This is why some case managers are making the
move and taking jobs with private companies. They feel that like other states, mental health and intellectual disability services will eventually move to mostly
private providers.
How can public agencies compete with private Managed Care
Organizations?
The introduction of CCC Plus will change the way public
agencies provide services. Public agencies are not typically considered a business
because they often provide services free of charge to the consumer. However,
public agencies take in revenue from Medicaid and local tax payers in order to
operate to pay employees. Public agencies will have to adjust their operations
and adopt a more “business-like” approach to compete with private companies. Here are a few ideas I feel can help even the
playing field with private companies.
Research the
Competition – Find out what the competition is doing to and understand why
your employees are leaving. See what the competition is doing and try to
replicate and improve their techniques. Restaurants, department stores, and other businesses do
it all the time. It’s time for public agencies to learn how to compete.
Embrace Teleworking- The
option to telework is one of the key reasons case managers are
choosing to work for private companies. Teleworking has also been shown in some
cases to
improve productivity
and morale. The "old-school" way of clocking
in and out is pretty much obsolete in the area of case management. So much of
the job can be conducted at home or off site such as phone calls, notes, and
reports. The old way of thinking is that “if we don’t see you then you’re not
working”. The new way of thinking embraces the flexibility and convenience that
teleworking can provide.
Rewards for
Performance- I think this can be a huge morale booster and can improve performance.
Private companies do this all the time and I believe that public agencies can
benefit from providing incentives for performance. When I mean incentives I’m
not talking about movie tickets or water bottles. I’m taking about financial incentives
in the form of bonuses. Here are a few things that can be incentivized:
*Timely Paperwork
*Taking on Additional
Cases
*Taking Difficult
Cases
*Exceptional
Performance
Embracing practices traditionally used by private companies
can help public agencies compete. Public agencies have a current advantage because they have been the number one choice
for so many years and have case managers that are more experienced with mental
health and intellectual disabilities at this time. This is the time to develop strategies
to compete because private case management is here to stay.
