Delivering Care, Billing, and Getting Paid Under CalAIM in LA County | Mental Health America of Los Angeles

Mental Health America of Los Angeles(MHALA) and Qualifacts – A Success Story

“Teamwork. Collaboration. Experience working together across teams inside our organization. Deep subject matter expertise. Leadership and staff showing up and pitching in. It took all of the above to understand the CalAIM changes that were coming our way,” said Monica Davis, MBA, Chief Administrative and Contracts Officer for Mental Health America of Los Angeles (MHALA). “When we chose Qualifacts as our EHR vendor to take us there, we had our plan for how to work together to implement the new system ahead of these changes.”

“Some in our larger community and peer organizations have not successfully submitted claims under CalAIM, but MHALA has made it work, thanks to the strengths and the efforts of our extraordinary team, and the flexibility of the CareLogic EHR,” Davis said. “Our ability to manage the conceptual changes, workflow changes, and services and documentation changes ourselves within the EHR has been crucial.

Preparing for Changes and Success

“We began to evaluate Qualifacts and the CareLogic EHR platform, because we had outgrown the constraints of our previous EHR platform,” said Courtney Stephens, PhD, MHALA Senior Director of Evaluation and Compliance. “We knew Medi-Cal and CalAIM changes were coming, along with the movement toward value-based care, and we needed to support those waves of change.”

MHALA also needed a Los Angeles County specific EHR platform certified to support the county’s Integrated Behavioral Health Information System (IBHIS). CareLogic’s integration with IBHIS offers ease of use and the capability to automate some functions and improve workflow efficiency.

Beyond the compliance requirements, MHALA needed to decrease clinical documentation time and effort, and gain reporting and analytics insights to support its metrics. “We wanted it to be easier for our clinical staff to complete documentation, our finance staff to manage billing and financial reporting, and our compliance staff to get the data and reporting they need. Now, with CareLogic, we can manage workflow changes ourselves,” Davis said. “We designed our forms and workflows with the clinical aspects of CalAIM in mind, and with the reporting we needed from the data gathered.”

Implementation Success

As a leader in the California behavioral health space, MHALA is known for innovative work with a variety of populations benefitting from wraparound services, and often participates in state-wide pilot programs. Ongoing innovation, growth, and expansion of programs and services means organizational change and adaptation are frequent realities.  “With the CareLogic EHR, our team can manage it, test it, and prove it. If we need to change it because the rules change or our understanding changes, we can adapt,” Davis said.

Davis called out kudos for MHALA’s implementation success for members of her organization and the specialists Qualifacts deployed phase by phase. “Our success with CalAIM was because we had the right people in place to get it all to work. Our team members were there throughout the process, working with the Qualifacts team to structure our workflows, so the right information appears in the right sequence, and to tie our codes and services to billing and claims,” Davis said. “The approach that Qualifacts took with the configuration and the setup was beneficial. We worked together as experts who understand our business, and Qualifacts brought their experienced team members in for each component. Today, we have a system that will grow with us.”

Claims, Billing and, Getting Paid Under CalAIM Success

“The CareLogic EHR has enabled us to successfully bill and get paid under CalAIM, which is more than a billing change, and more than a backend change – it’s changing how we operate clinically and how we deliver services,” Davis said. “Other behavioral health organizations were surprised that MHALA had successfully sent claims and had gotten paid using Qualifacts CareLogic EHR after CalAIM went live, because they were experiencing difficulties with their EHRs.”

Ongoing Support

MHALA looked to Qualifacts and its CareLogic EHR for continuous updates and enhancements to the platform, along with the flexibility to manage day-to-day changes themselves. “The Qualifacts team has been very responsive to our questions,” Davis said.

Reporting and Business Intelligence Success

“We are using several of the CareLogic EHR reporting tools, including those intended for experts and others for less experienced users,” Stephens said. “Team members are gaining skills, and we are getting metrics we didn’t have before.”

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About Mental Health America of Los Angeles (MHALA)

Mental Health America of Los Angeles works to ensure that people with mental health needs achieve meaningful, healthy lives in their communities. They serve low-income adults and transition-age youth facing mental health needs, including Veterans and people experiencing homelessness. MHALA provides mental and physical healthcare, employment, housing, and education services to nearly 16,000 individuals throughout Los Angeles County. MHALA uses an integrated, comprehensive service model that meets each individual where they are, and tailors services to each person’s needs. Their services are strength-based and delivered by teams of interdisciplinary professionals.

About CalAIM

The multi-year California initiative to improve the quality of life and health outcomes of the state’s population is designed to support whole-person, integrated care and move to a more consistent and seamless system by reducing complexity and increasing flexibility while improving quality outcomes, reducing health disparities, and drive delivery system transformation and innovation through improvements to behavioral health policies and the launch of behavioral health payment reform. The majority of these policy changes launched in 2022, but implementation will continue through 2027.

Qualifacts EHR Solutions for California 

As interoperability and reporting requirements evolve, having a comprehensive EHR is vital for coordinating that care with Los Angeles County’s Integrated Behavioral Health Information System (IBHIS), adhering to the challenges of CalAIM initiatives, and getting paid under CalAIM behavioral health payment reform.

Qualifacts offers Los Angeles County tailored EHRs, training, and support to simplify these complexities, allowing you to work more efficiently, maximize revenue, and demonstrate high performance. Our highly configurable, innovative, and scalable EHRs are designed to support providers’ core operations and adapt to the ever-changing landscape. Learn more about our solutions: Behavioral Health & Human Service EHRs for Los Angeles County Providers

Contact an EHR Software Expert

At Qualifacts, we are committed to serving behavioral health, rehabilitative (PT/OT/SLP), and human services organizations by providing top-rated EHR solutions and services. Our team consists of seasoned professionals with hands-on clinical and administrative experience in these vital service areas. We understand the unique challenges you face and are here to assist you in selecting the most suitable solutions for your organization’s needs. Let’s kickstart the conversation that can transform your services. Complete this brief form to get started.