A comparison of how behavioral health organizations utilize training to prepare for health care reform

Victoria Stanhope, Mimi Choy-Brown, Stacey Barrenger, Jennifer Manuel, Micaela Mercado, Mary McKay, Steven C. Marcus

    Research output: Contribution to journalArticle

    Abstract

    Background: Under the Affordable Care Act, States have obtained Medicaid waivers to overhaul their behavioral health service systems to improve quality and reduce costs. Critical to implementation of broad service delivery reforms has been the preparation of organizations responsible for service delivery. This study focused on one large-scale initiative to overhaul its service system with the goal of improving service quality and reducing costs. The study examined the participation of behavioral health organizations in technical assistance efforts and the extent to which organizational factors related to their participation. Methods: This study matched two datasets to examine the organizational characteristics and training participation for 196 behavioral health organizations. Organizational characteristics were drawn from the Substance Abuse and Mental Health Services Administration National Mental Health Services Survey (N-MHSS). Training variables were drawn from the Clinical Technical Assistance Center's master training database. Chi-square analyses and multivariate logistic regression models were used to examine the proportion of organizations that participated in training, the organizational characteristics (size, population served, service quality, infrastructure) that predicted participation in training, and for those who participated, the type (clinical or business) and intensity of training (webinar, learning collaborative, in-person) they received. Results: Overall 142 (72. 4%) of the sample participated in training. Organizations who pursued training were more likely to be large in size (p = .02), serve children in addition to adults (p < .01), provide child evidence-based practices (p = .01), and use computerized scheduling (p = .01). Of those trained, 95% participated in webinars, 64% participated in learning collaboratives and 35% participated in in-person trainings. More organizations participated in business trainings than clinical (63.8 vs. 59.2%). Organizations serving children had higher odds of participating in both clinical training (OR = 5.91, p < .01) and business training (OR = 4.24, p < .01) than those that did not serve children. Conclusions: The majority of organizations participated in trainings indicating desire for technical assistance to prepare for health care reform. Larger organizations and organizations serving children were more likely to participate potentially indicating increased interest in preparation. Over half participated in business trainings highlighting interest in learning to improve efficiency. Further understanding is needed to support organizational readiness for health care reform initiatives among behavioral health organizations.

    Original languageEnglish (US)
    Article number19
    JournalImplementation Science
    Volume12
    Issue number1
    DOIs
    StatePublished - Feb 14 2017

    Fingerprint

    Health Care Reform
    Organizations
    Health
    Mental Health Services
    Learning
    Health Services Misuse
    Health Services Administration
    Logistic Models
    Patient Protection and Affordable Care Act
    Costs and Cost Analysis
    Evidence-Based Practice
    Medicaid
    National Health Programs
    Population Characteristics
    Population Density
    Health Surveys
    Health Services
    Substance-Related Disorders
    Multivariate Analysis
    Databases

    Keywords

    • Organizational behavior
    • Policy reform
    • Research-practice partnerships

    ASJC Scopus subject areas

    • Medicine(all)
    • Health Policy
    • Health Informatics
    • Public Health, Environmental and Occupational Health

    Cite this

    Stanhope, V., Choy-Brown, M., Barrenger, S., Manuel, J., Mercado, M., McKay, M., & Marcus, S. C. (2017). A comparison of how behavioral health organizations utilize training to prepare for health care reform. Implementation Science, 12(1), [19]. https://doi.org/10.1186/s13012-017-0549-0

    A comparison of how behavioral health organizations utilize training to prepare for health care reform. / Stanhope, Victoria; Choy-Brown, Mimi; Barrenger, Stacey; Manuel, Jennifer; Mercado, Micaela; McKay, Mary; Marcus, Steven C.

    In: Implementation Science, Vol. 12, No. 1, 19, 14.02.2017.

    Research output: Contribution to journalArticle

    Stanhope, V, Choy-Brown, M, Barrenger, S, Manuel, J, Mercado, M, McKay, M & Marcus, SC 2017, 'A comparison of how behavioral health organizations utilize training to prepare for health care reform', Implementation Science, vol. 12, no. 1, 19. https://doi.org/10.1186/s13012-017-0549-0
    Stanhope, Victoria ; Choy-Brown, Mimi ; Barrenger, Stacey ; Manuel, Jennifer ; Mercado, Micaela ; McKay, Mary ; Marcus, Steven C. / A comparison of how behavioral health organizations utilize training to prepare for health care reform. In: Implementation Science. 2017 ; Vol. 12, No. 1.
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    abstract = "Background: Under the Affordable Care Act, States have obtained Medicaid waivers to overhaul their behavioral health service systems to improve quality and reduce costs. Critical to implementation of broad service delivery reforms has been the preparation of organizations responsible for service delivery. This study focused on one large-scale initiative to overhaul its service system with the goal of improving service quality and reducing costs. The study examined the participation of behavioral health organizations in technical assistance efforts and the extent to which organizational factors related to their participation. Methods: This study matched two datasets to examine the organizational characteristics and training participation for 196 behavioral health organizations. Organizational characteristics were drawn from the Substance Abuse and Mental Health Services Administration National Mental Health Services Survey (N-MHSS). Training variables were drawn from the Clinical Technical Assistance Center's master training database. Chi-square analyses and multivariate logistic regression models were used to examine the proportion of organizations that participated in training, the organizational characteristics (size, population served, service quality, infrastructure) that predicted participation in training, and for those who participated, the type (clinical or business) and intensity of training (webinar, learning collaborative, in-person) they received. Results: Overall 142 (72. 4{\%}) of the sample participated in training. Organizations who pursued training were more likely to be large in size (p = .02), serve children in addition to adults (p < .01), provide child evidence-based practices (p = .01), and use computerized scheduling (p = .01). Of those trained, 95{\%} participated in webinars, 64{\%} participated in learning collaboratives and 35{\%} participated in in-person trainings. More organizations participated in business trainings than clinical (63.8 vs. 59.2{\%}). Organizations serving children had higher odds of participating in both clinical training (OR = 5.91, p < .01) and business training (OR = 4.24, p < .01) than those that did not serve children. Conclusions: The majority of organizations participated in trainings indicating desire for technical assistance to prepare for health care reform. Larger organizations and organizations serving children were more likely to participate potentially indicating increased interest in preparation. Over half participated in business trainings highlighting interest in learning to improve efficiency. Further understanding is needed to support organizational readiness for health care reform initiatives among behavioral health organizations.",
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