Projects & Impact

AHP has built its business on applying best practices, many of which we have helped to shape, and real-world, hands-on knowledge to improving systems and business practices for our clients.

In all of the work that we do, we are guided by our mission to improve health and human services systems of care and business operations to help organizations and individuals reach their full potential.

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Building a Behavioral Health Network with Rural Providers

Facing evolving state and federal requirements for clinical integration, this group of rural behavioral health providers sought AHP’s help to assess their capabilities and begin to build a provider network to better serve their region. Recognizing the competitive risk of more dominant health systems, these smaller providers have banded together and are collaborating with AHP to strengthen their administrative capacity and efficiency and deliver care more effectively. AHP is conducting a readiness assessment of each provider’s capabilities for forming a provider network model with an analysis of strengths and weaknesses, along with recommendations for the most suitable network model to pursue. In addition, AHP is developing a business planning process with a blueprint for implementation for the chosen model. Each organization will receive a feasibility study and business plan for establishing a shared services organization.

Developing a Managed Service Organization for an Intellectual/Developmental Disability Services Provider Association

Members of an intellectual/developmental disabilities (I/DD) providers association engaged AHP to help form a management service organization (MSO) in response to imminent changes in the regulatory and business environment driven by the Affordable Care Act. AHP conducted a readiness assessment and then developed an implementation plan and roadmap to guide the group of providers toward establishing the MSO to re-engineer care delivery systems and adopt integrated service solutions and new technology. The comprehensive roadmap outlined the functional processes to put in place and a set of recommendations and procedures to help launch the MSO for the providers.

Increasing Financial Stability and Productivity for an Intellectual/Developmental Disability Service Provider

AHP helped to assess and improve key business operations for The Resource Center, a provider of intellectual/developmental disability, primary care, dental, and mental health services in New York State that was facing financial challenges under health care reform. Over a two-year period, AHP conducted a claims analysis and a productivity study, as follows:

  • The analysis identified the causes of financial losses, gaps in the revenue management process, and opportunities for improved pricing strategies and contract negotiation processes.
  • The productivity study analyzed the clinical workflow and its impact on revenue models, revealing both the need to improve productivity and to increase patients to the practice. AHP’s recommendations from all phases of work were quickly implemented by the client. Today operations are more efficient, productive, and profitable.

Positioning a Provider of HIV/AIDS Services in the Managed Care Market

AHP developed a strategic plan for this nonprofit provider of services for individuals with HIV/AIDS, focused on new products and services arising from health care reform opportunities, specifically guiding the organization in expanding its services to managed care organizations (MCOs). Once in place, the plan laid a foundation for AHP to help the client develop proposals to solicit contracts for specialized managed care services to the HIV/AIDS and other vulnerable populations. These proposals were submitted to major managed care insurers with plans targeting the Medicaid long term care services markets.

Transitioning to a Medicaid Managed Care Model for Providers of Services to Individuals with Disabilities

AHP is supporting this provider association in its goal of establishing a long-term Medicaid managed care model for its member organizations that deliver services to individuals with physical disabilities. The managed care model will ensure care coordination between patient primary and mental health services, as well as facilitate their ability to live and work in integrated settings. In addition, the work explores network provider models to create a shared organizational infrastructure that will produce administrative and information technology efficiencies for the new managed care model. AHP is currently conducting readiness assessments and providing recommendations for best practices and models that best fit the organizations while meeting state regulatory requirements.

Developing a Strategic Plan and Pro Forma to Help a Midwestern Provider Association Form a Behavioral Health Network

This provider association engaged AHP to help form a provider network from among its members. AHP developed a robust strategic business operational plan and pro forma by performing in-depth analyses of key business operations areas and developing an action plan. Building on that work, AHP then facilitated the implementation planning process for credentialing and billing. As a result, AHP delivered a comprehensive roadmap outlining the functional processes to institute and a set of recommendations and procedures to help launch the desired network.

Improving Technological and Business Efficiencies for Federally Qualified Health Centers (FQHCs)

Since 2005, AHP has helped nearly all Massachusetts FQHCs and others in the Northeast and Mid-Atlantic to re-engineer key operational and clinical processes. AHP delivers value to the bottom line through evaluating and improving process mapping and workflow analysis, EHR implementation, identification of barriers and constraints, clinical and operational staff training, and system validation. AHP experts help FQHCs to integrate primary care and behavioral health, conduct strategic planning to meet the requirements of health care reform, and perform protected health information privacy and security assessments. Since 2011, AHP has assisted FQHCs in meeting the Centers for Medicare and Medicaid Meaningful Use.

Positioning an Accountable Care Organization to Expand Behavioral Health Services

Inspira Health Network, an accountable care organization (ACO) with three medical centers and more than 100 access points, sought AHP’s help to make rapid, well-informed decisions about the best allocation of its behavioral health resources and facilities to best serve the surrounding community and deliver value to the bottom line. The goal was to research and deliver a position paper for presentation to legislative, business, and community stakeholders that would encourage support for the ACO’s proposed facility and product expansion. In a very tight timeframe, AHP conducted an assessment of the existing and future business environment, researched and defined the product line and proposed expansion, and developed a paper positioning Inspira Health Network and the benefits proposed for the community.

Redesigning Systems for the Substance Use Disorder Field in the Era of Health Care Reform

In 2011, AHP foresaw the coming impact of both the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA) on the substance use disorder (SUD) field. Working with the State Associations of Addictions Services (SAAS), the largest national association of SUD treatment and service providers at the time, AHP developed an approach to assess and redesign the nation’s SUD delivery system. Together SAAS and AHP deployed the Readiness and Capabilities Assessment (RCA), a jointly developed survey tool to measure provider ability to meet the expected demands of the new legislation.

Related resources and publications:

Redesigning the Substance Use Disorder Treatment Continuum of Care in Los Angeles County

AHP is working with the Los Angeles County Department of Public Health Substance Abuse Prevention and Control (SAPC) to support the county in developing a state-required plan to opt into the Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver for adult and adolescent populations. The waiver expands treatment and recovery services and creates a continuum of care for individuals diagnosed with a substance use disorder (SUD).

In partnership with the SAPC leadership and other key stakeholders, AHP is developing the financing formula and the organizational and staffing infrastructure that will support the DMC-ODS. To fully develop the architecture and financing recommendations, AHP is analyzing similar systems, studying rate setting methodologies, providing comprehensive data analysis, evaluating financial formulas, cross-walking ASAM levels of care with standardized code sets, and gathering information on managed care financial operations. AHP will also provide recommendations for a cost-effective training plan to develop the staffing capabilities and readiness for implementation of the new system.

Supporting the Illinois Alcoholism and Drug Dependence Association in its Advocacy for Substance Use Disorder and Mental Health Services

AHP has supported long-time client and partner, the Illinois Alcoholism and Drug Dependence Association (IADDA), on several key policy, marketing, and system design initiatives. In 2012, AHP reviewed and analyzed state insurance laws and regulations, and made recommendations concerning substance use disorder (SUD) policy and coverage. Subsequently, in light of Illinois’ decision to expand Medicaid in a coordinated care organization context in 2013–2014, AHP conducted an environmental scan to identify gaps in the statewide system of care that, if filled adequately, would result in an “ideal system design.” In 2014, AHP provided a review and set of recommendations for cost rates of behavioral health services in Illinois. The resulting document showed current rates were under national norms, and the data was used by IADDA in lobbying efforts to adjust provider rates in the state.

Supporting Transition to Health Care Reform for a Large National Behavioral Health/Social Services Organization

AHP worked with this national association and its affiliate members around the country on a range of projects including re-engineering services and delivery systems in response to the requirements and opportunities under the Affordable Care Act. AHP has worked extensively with the national headquarters of the association to identify opportunities for affiliates, including identifying partnerships with health homes and accountable care organizations, exploring new business opportunities, and expanding publicly funded services into the private pay and third party/managed care markets.
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