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Susan Milstrey Wells

National Council for Behavioral Health

A Roadmap for Success: Analyzing What It Takes to Get Your Organization in Gear

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The American health care system is rapidly evolving, and mental health and substance use treatment providers are struggling to catch up. Value-based payments, performance-based contracting, population health management ­– it’s enough to make your head spin. The destination is still the same – providing affordable, accessible, science-based treatment and services for mental illnesses and substance use disorders. But getting there can feel like traveling at a high speed without a GPS or roadmap.

You are asked to serve increasing numbers of individuals with multiple and complex needs. You are required to attract and contract with multiple payers, many of whom may be unaware of your organization and the services you offer. You are charged with meeting ever-changing regulations at the state and federal level. All of this takes time and money, and you have too little of both.

Any number of these pain points may suggest the need to change course. Often, it’s a problem with the bottom line. “Most organizations that come to us for help are having some sort of financial difficulty,” says MTM Services consultant Foster Norman. “They want to know what they’re not doing, or what they need to do differently.”

But everything you do feeds into your bottom line, from staffing and technology to clinical practices and business operations, so it can be difficult to tease out where the problem lies. To succeed in a 21st century health care system, behavioral health providers must embrace five essential values. They must:

  • Be connected, by focusing on serving people and providers, rather than simply meeting system requirements.
  • Be accessible, by shifting focus from scheduling appointments to service provision.
  • Be efficient, by covering the actual cost of care while increasing capacity to provide high-quality services.
  • Be accountable, by demonstrating that care is improving.
  • Be willing to change, by driving organizational change and not letting it drive you.

This can seem like a tall order and might lead you to identify the wrong problem. You might pin the cause of employee and consumer dissatisfaction on expanded infrastructure, while overlooking the role of communication in helping employees and consumers embrace your envisioned future.

Or you may blame your inability to see new consumers on the fact that you are so busy, you are booking four to six weeks in advance. But you may fail to understand the “false reality of full,” which reveals that when you schedule folks that far in advance, a fair percentage of them don’t show up for their appointments. That means there are open slots. Your organization isn’t full, it’s just scheduled full.

These are the kind of inconsistencies that can be uncovered by performing a complete organizational analysis, one that examines organizational structure, management, work environment and clinical and business operations and assesses performance, effectiveness and efficiency in each of these areas. When performing reviews, Norman relying on his 40 years of experience serving individuals with intellectual/developmental disabilities and management of mental health and substance use disorder direct service and Medicaid managed care organizations, including 16 years as a chief executive office, often ends up making specific recommendations that go far beyond the issue on which an agency seeks help. He might be called in to review organizational structure and end up recommending changes in clinical practices and human resource policies.

Often, organizations that feel they are wandering in the wilderness – with wasted resources, lack of focus and no long-term plans – decide to take the bull by the horns and create a formal strategic plan. This requires a committed planning group meeting over several days, Norman points out.

A good two to four-year plan defines your mission, vision and values and identifies your organization’s strengths, areas for improvement, opportunities, threats and barriers. It includes broad goals, specific objectives and measurable strategies, with timelines and responsible parties. An effective strategic plan can help you achieve a balance between quality services and efficiency. It gives you a roadmap to achieve positive health outcomes as well as improve your agency’s bottom line.

We know that providing affordable, accessible, science-based treatment for mental illnesses and substance use disorders is your true north, and you won’t stop until you reach your destination. Are you ready to learn more about how organizational analysis and strategic planning can help you get there? For more information, contact Foster Norman of MTM Services at