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BHO

The Western Regional Behavioral Health Organization (WRBHO) is responsible for monitoring inpatient behavioral health services for individuals in the fee-for-service Medicaid population within the 19- county Western region of New York State. The WRBHO team is comprised of staff from:

  • The New York Care Coordination Program (NYCCP) who is responsible for engaging local governments, providers, and peers in the BHO program, overseeing implementation, monitoring program performance, and supporting local development of managed service systems.
  • Beacon Health Strategies (Beacon), a NCQA accredited Managed Behavioral Health Organization, who is responsible for concurrent inpatient utilization review, monitoring inpatient discharge planning, and working with inpatient facilities, outpatient providers, and local governments to ensure appropriate service planning and continuity of care of high needs individuals.
  • Coordinated Care Services, Inc (CCSI), who will work closely with Beacon to analyze, summarize, and disseminate data gathered through the BHO process to help quantify system and provider performance on key dimensions, identify service gaps and other opportunities to improve service coordination, quality and outcomes and to track progress over time.

Specific BHO responsibilities include:

  • Concurrent review of behavioral health inpatient length of stay;
  • Reducing unnecessary readmissions;
  • Improving rates of engagement in outpatient treatment following discharge;
  • Gathering information on the clinical conditions of children with a Serious Emotional Disturbance who are covered by Medicaid Managed Care and receiving treatment in an OMH licensed specialty clinic;
  • Profiling provider performance; and
  • Facilitating cross-systems linkages.