Lawmakers heard arguments recently on how to use data to better deliver behavioral healthcare across the state.
The company Falling Colors has administered New Mexico’s behavioral health care system since 2017. That can include paperwork, customer service and processing claims.
And by the numbers, it’s doing a good job. It pays providers in less than six days on average, and only rejects an average of 7% of claims. According to a federal report, that’s less than half of the national average of 12.5% by comparable managed care organizations, which deal with general health care.
Company officials said New Mexico lawmakers can learn from their success.
Chief Operating Officer Sam Wolf told members of the Health and Human Services Committee said the key is having access to real-time data. He said that helps the company make quicker, more effective decisions, which lawmakers can benefit from.
“We deliver data so that everybody who is looking at it can see and understand what's happening with the funds that are being spent,” he said. “We've brought millions of dollars back into the agencies to be spent on other programs.”
CEO Jorie Koster-Hale said data collection has also helped the company effectively evaluate which behavioral health programs work best under different situations and for different groups of people, which then directs where patients should go to get the best outcomes.
“Behavioral health care requires the capacity to pivot and expand at the drop of a hat,” she said. “As anyone who's tried to stand up a new program knows, inevitably it will require changes in process, data collection and even core goals.”
She suggested state lawmakers design legislation that directly provides them with that sort of data, so they can make the same kind of informed decisions within their committees and when drafting legislation.
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