Medicaid expansion allows for the redesign of services that support community based care to improve care delivery with direct rehabilitative and stabilization services to consumers and their family. These new service opportunities encompass both adults as well as children across clinical populations and special needs groups. However, planned and informed decisions for these opportunities should be considered given the constraints of service rate reimbursements and practice requirements with responsive and, possibly, costly infrastructure changes. New service activities should complement existing current services; however, the internal processes, such as billing and documentation may be a wider process change with new workflows, training and protocols. Billing, for example, must be established with the managed care company and the credentialing of appropriate staff can be very lengthy. A planned launch of services must take this into consideration because billing cannot occur until all managed care contracting have been completed and approved.
The implementation of a new service model is a transformative growth opportunity. It is a time to refine existing Agency infrastructures that can transform the practice of care delivery, address shifts in the business model and identify changes in revenue management and quality improvements. SAE can assist with all levels of Agency Transformations with a Rapid Assessment, Implementation and Service Launch, and Initial Monitoring of new service model changes.