How can Medicaid health plans achieve optimal outcomes for their members
that need Applied Behavior Analysis (ABA) services while also ensuring appropriate service utilization?
Health plan leaders are challenged with providing quality, evidenced-based ABA services for a small segment
of their member populations diagnosed with Autism Spectrum Disorder (ASD) while also being tasked with finding
strategies to lower the cost of care. Through proactive planning, program monitoring, and provider engagement,
health plans can effectively manage this high-cost service and improve the lives of these members and their families.
Learn how health plans are enhancing management of ABA services through analytics, provider monitoring, and clinical quality oversight.
• Establish a provider monitoring program to ensure appropriate utilization, lower cost of care, and improved member outcomes
• Build an ABA provider network that delivers high quality services
• Understand how monitoring provider adherence to required ABA elements translates into cost savings and regulatory compliance
• Methods for developing a collaborative relationship with ABA providers and advocates so that ABA quality can be monitored
Angela Fero, LCSW, Director of Operations-Behavioral Health, Alliant ASO
Angela Fero is a licensed clinical social worker and the Behavioral Health Director of Operations for Alliant ASO. With 20 years of clinical and administrative experience in all levels of care, she partners with managed care companies to monitor the quality of their behavioral health networks. Cost savings initiatives have resulted in identifying more than $18.5 million in potential savings to managed care companies from provider audits, and millions more in projected savings from lower cost of care following provider engagement. Additionally, the audit findings have been used to substantiate investigations at the state level. In previous managed care roles, her team’s focus on quality of care and documentation ultimately reduced the length of inpatient hospitalization from 340 to 160 days, saving Medicaid up to $10M annually. As a Lean Six Sigma Green Belt she is a respected and dynamic community leader focused on continuous improvement with a passion for quality behavioral health care that improves member outcomes and provider education.
Dr. Lynn Bradford, PhD, Director of Program Development-Behavioral Health, Alliant Health Solutions
Dr. Lynn Bradford, PhD is a licensed psychologist with 27 years of experience. She spent fifteen years in clinical work that included direct care experience with children and adults providing therapy, testing, supervision and research coordination. Dr. Bradford has spent the past eleven years in healthcare administration as a Director of Behavioral Health in Medicaid Managed Care. Quality improvement and cost of care projects led by Dr. Bradford resulted in improved outcomes for members and achieved cost savings for the health plan. A thought leader on integrated healthcare and behavioral health, Dr. Bradford’s expertise is sought by state agency leaders in Medicaid and Department of Mental Health and Addiction. She is a past presenter at national conferences on the topic of integrated health care. Currently, she is the Director of Program Development for Behavioral Health at Alliant Health Solutions.
Who Should Attend:
Medicaid Health Plans
Decision makers from:
• Quality
• UM/ Behavioral Health
• Finance
• Program Integrity (SIU)
• Provider Relations
Alliant ASO, a division of Alliant Health Group, provides commercial health plans and private sector businesses services expertise and information systems necessary to increase the effectiveness, accessibility and value of health care. While being led by clinicians, driven by technology and guided by policy, Alliant works to make health care better. Alliant ASO, creates customized, integrated healthcare solutions that ensure patients are receiving high quality, medically necessary services in the appropriate setting. Our services enable our customers to meet the challenges of today's health care environment as they improve the health and outcomes of individuals. As an expert resource in the public sector market in health care management and information services, Alliant ASO has developed an in-depth understanding of health care delivery, clinical care and financing.
Featuring leading systems technology and a background of experienced professionals, Alliant offers integrated management services and clinically appropriate care in a way that is cost-effective and financially beneficial. Utilization management, quality improvement, program integrity audits and medical reviews are a few of the solutions and services provided from Alliant’s practicing physicians and allied health professionals representing 60 clinical specialties. Alliant’s medical decisions are evidence-based and backed by the use of nationally accepted criteria. These abilities, coupled with commitment and focus on innovation, helped to create the keystone of Alliant’s success for the past 50 years.
