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Certified Community Behavioral Health Clinic Service Sheet

Program Development

FTI Consulting is an independent global business advisory firm dedicated to helping organizations manage change, mitigate risk, and resolve disputes. Our Healthcare Risk Management & Advisory team serves the entire Healthcare ecosystem. Our team includes subject matter experts that help CMS establish the rules, regulations, and financial tools to administer programs. We specialize in providing technical assistance for the CCBHC demonstration: cost report compliance, revenue cycle management, program oversight, quality bonus payments program development and administration, cost report audit support, organizational transformation and strategic planning.

Our Approach

Strategy and Compliance
Our CPAs, clinicians and financial professionals can walk you through developing your entire CCBHC program, including the CCBHC cost reporting process to establish a prospective payment system rate, while understanding short term and long-term goals while you build your CCBHC program. We guide you through Medicaid rules and help you create sustainable, efficient operations to make your CCBHC program successful.

National Council for Mental Wellbeing - Bronze Sponsor

FTI Consulting is excited to partner with the National Council to help transform the behavioral healthcare industry. We are happy to serve both states and clinics in developing their CCBHC programs by providing a complimentary 30-minute technical assistance call. Our specialty is cost reporting and PPS payment operations.

What We Offer to States

Program Expertise
Our team at FTI Consulting has been involved with the CCBHC concept since the Protecting Access to Medicare Act passed in 2014. Our cost report experts helped design the original template in 2016 and the revised template in 2023 for states in the federal CCBHC demonstration. Our experience allows us to help you develop and maintain CCBHC program operations to join the federal demonstration or work under a state plan amendment. We will walk you through the necessary steps to assess statewide needs, develop a scope of services and activities that your prospective payments will cover, provide cost report training and audit support, and transition from fee-for-service to a monthly or daily rate for CCBHC and crisis services, and evaluate provider readiness for certification.

Reconciliation and Reporting Support
Changing operations for prospective payments can be daunting. Our experts can help your finance teams modify their systems to manage bundled payments for services and reconcile Medicaid payments to ensure payment is correct, including support for wraparound payments.

Planning Grants and Demonstration Application Support
Planning Grants are designed to provide states the resources necessary to develop a plan for joining the CCBHC Demonstration. Our team are experienced assisting states with CCBHC Planning Grants application and completing the work to craft a CCBHC Implementation Plan that supports a successful Demonstration Application. Our teams work collaboratively through all phases of CCBHC program development:

Obtaining the planning grant
Leveraging the planning grant funding to build a strong implementation plan for your CCBHC Demonstration Application
Determining the right PPS model for your state, and
Designing a quality bonus payment model aligned with your program improvement goals.

What We Offer to Clinics

Technical Assistance
Our expertise in the program allows us to help clinics set up prospective payment the right way to ensure patients continued access to quality behavioral healthcare. We offer technical assistance with all aspects of being a CCBHC including completing a community needs assessment and cost reporting. We help clinics identify needs for certification and support development of anticipated costs and visits in the first year of operations. For ongoing support, we provide payment reconciliation and revenue cycle management and developing dashboards for key metrics that help monitor visit levels, provider productivity, and PPS rate impact for continued success.

Cost Reporting
FTI Consulting was instrumental to CMS when developing the CCBHC cost report in 2016 and again in 2024. FTI Consulting can bring that expertise to clinics to help them complete the cost report, pass the audit or desk review and implement financial reporting to support life under the PPS. Our cost report model and supporting documentation has worked for over 40 clinics since 2022.

Community Needs Assessments
States use the Community Needs Assessment (“CAN”) to validate costs within your CCBHC cost reports. Our team includes experts in conducing CNA’s and creating CCBHC cost reports, ensuring that your CNA correctly identifies service gaps and other resource needs for your program. Our team is experienced in quantifying service and staffing gaps and other infrastructure needs into staffing and anticipated costs within your cost reports to optimize your PPS rate.

Infographic steps: demographics; needs; clinic services; community resources; identify and quantify gaps; CCBHC cost report.

CCBHC Executive KPI Dashboard
Management of your CCBHC program requires the right information for your leadership teams at the right time and in an actionable format. We have designed a CCBHC Dashboard that tracks key performance indicators for the CCBHC program in an interactive data dashboard.

Diagram of CCBHC KPI Dashboard linking metrics for financials, members, personnel, visits, services, and quality performance.

CCBHC Executive KPI Dashboard Elements:

CCBHC Visits: Daily/monthly visits to estimate PPS payments
CCBHC Services: Type and intensity of service utilization by provider and members
Quality Measures/Quality Bonus Payment (“QBP”) Performance: Clinic and state reported CCBHC quality measures and QBP performance
FTE and Personnel: Staffing, utilization per staff, and productivity
Member Metrics: Demographics, diagnoses, payer mix and utilization patterns
Financial Metrics: Profitability, cash flow, cost/per visit, forecasting and financial stability

CCBHC Certification Readiness
Our readiness support ensures your clinic is fully prepared to meet all CCBHC Certification requirements including any evidence-based practices your state may require. More than a ‘check the box’ exercise, we are CCBHC operations experts who ensure your program meets certification requirements with processes that optimize your operations and workflows. Our approach is hands-on with onsite interactions and participation in the certification evaluation, if desired.