Driving_Consistency_and_Compliance_in_Behavioral_Health_UM_with_LOCUS
0:02
Hello and welcome to today's webinar, Driving Consistency and Compliance in Behavioral Health, UM with Lopez.
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Before we get started, I'd like to review a few housekeeping details.
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Today's webinar is being recorded and an online archive of today's event will be available within one to two business days.
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And finally, I'd like to remind you of Ahips antitrust statement located in the link just below the slide viewer.
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We will, as always, comply with that statement.
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Among other things, the antitrust statement prohibits us from discussing competitively sensitive information.
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We're very fortunate to have with us today Doctor Wesley Sowers, Medical Director at the American Association for Community Psychiatry and Laura Coughlin, Vice President of Innovation and Content Development at Optum.
1:30
At this time, I'd like to turn the floor over to the speakers.
1:36
Right, thank you.
1:38
So she mentioned we have Doctor Sowers with us from the AACP representing the Locus tool and myself Laura Coughlin from Optum and the Inter Qual team representing the solution that we're talking about today.
1:57
So for a high level agenda that we're going through, we will go over the trends and challenges in behavioral health, especially as it relates to utilization management.
2:10
We're going to talk about the Locus clinical framework and how that's set up.
2:14
And we're going to talk a little bit about integrating Locus into UM workflows, which is really important for payer and provider collaboration and then do a summary and a question and answer.
2:26
So in terms of the overall behavioral health, UM, landscape, it's probably like not lost on any of us.
2:31
The activity and the increase in market activity around utilization in behavioral health in three major areas, the regulatory area, access to care and payment under regulatory, there's increasing scrutiny, whether it's at the state level or the federal level in terms of audits, especially of payer organizations looking for really enforcement around mental health parity laws.
2:58
And a lot of tightened, heightened compliance as it relates to CMS and specifically Medicaid regulations as it relates to access to care.
3:08
Tons of blockers.
3:09
I'm sure it's not lost on any of us.
3:11
Since COVID, the demand for behavioral health services in this country is far outstripping the supply that we have.
3:19
The workforce shortages even more are impacting this.
3:22
So we have increased demand, decreased supply, and so more important than ever that patients get appropriate care and that we utilize the full continuum of care to help those patients get the services that they need.
3:35
And there are constantly persistent geographic and socioeconomic disparities that exist, deserts if you will, for behavioral health care across the country in terms of payment, a lot of accountability and oversight going on.
3:49
We're seeing the shift to value based care, especially in Medicaid behavioral health models and a lot of alignment is expected on coverage policy criteria, reimbursement decisions.
4:00
So that again along with mental health parity, we're being consistent in how payers are treating their mental health services compared to their medical surgical services and continued burden, just administrative burden, right of all the audits that that seem to go like this in cycles.
4:18
And lately we've been seeing sort of the upside cycle of that.
4:24
Also at now when you talk about LOCUS, specifically the level of care utilization system, there are increasing state and federal mandates around the use of this tool, medical society content around the management of behavioral health services for payers.
4:39
There are 6 states that are required across all lines of business to use the locust tool and instrument.
4:45
You can see there California, Connecticut, Illinois, Maryland, New York.
4:49
Although New York doesn't explicitly name locust, the guiding principles are very aligned with the locust dimensions.
4:56
And Oregon for Medicaid payers and providers are managing their Medicaid managed members and there are 26 states plus the District of Columbia or DC where that's required and you can see the alphabetical list right there.
5:10
And lastly for providers, providers in 15 states are mandated by the state level to use locus and you can see the list of states right there.
5:20
And this isn't been an increasing trend over the years for that.
5:25
So we'll talk a little bit more about the tools to get us there.
5:29
So with that, I'm gonna turn it to Doctor Wes Sowers, who can go over for us the overview of Locust and go into a little bit depth of how it's used in the utilization management function.
5:40
And then I'll pick it back up there.
5:43
Wes.
5:44
OK, Thanks, Laura.
5:47
Afternoon, everybody.
5:49
I'm going to be providing some information about Locus, as Laura said, the level of care utilization system which I designed almost 30 years ago with my colleagues at the American Association of Community Psychiatry.
6:04
As Laura mentioned, it's becoming increasingly adopted by providers, payers and states to manage level of care decision making.
6:15
And I'm going to start by providing some context towards development and we'll finish up by thinking how it might help us address imminent mental health crisis that is looming.
6:30
We've spent, There we go.
6:33
We've spent.
6:34
I'm sorry We spent the last three decades struggling with how and by whom service intensity decisions should be made, and up until recently the answers have been fairly idiosyncratic and highly fragmented.
6:55
So how should we assess needs and manage resources in a way that consistently provides the correct amount of care to meet an individual's needs at a given time?
7:07
And it's not hard to see that standardization and integration will be important elements of increasing the value of the services we provide.
7:17
So to do this, we would want to be sure that there's a structured method of assessment that consistently considers all the factors that contribute to an individual's needs.
7:28
And we would want to have a seamless continuum of service intensities that can accommodate those needs as they evolve and a simple way to match needs and services.
7:40
Standardization of those processes would provide a common language for all stakeholders, enhance quality improvement efforts, reduce fragmentation and administrative waste and the redundancy that's often occurring in our systems, and place the emphasis back on quality, continuity and equitable distribution of resources.
8:09
Takes a minute for these to change.
8:12
There we go.
8:15
So there's been many challenges that we've encountered with the way that we've skewed standardization in the past.
8:23
There have been multiple sets of medical necessity criteria developed by various companies.
8:29
Many of them focus primarily on reducing costs at the expense of quality in many cases.
8:37
So some of the challenges that occur with those criteria sets is that they're often complex and cumbersome and rigidly defined.
8:47
Many of them are, I'm sorry, got the wrong slide here, here we go, sorry.
8:58
Many of them are proprietary and difficult to access or understand.
9:03
There's been a focus on acuity rather than longer term recovery, with limited relationships to individualized treatment plan, and the lack of transparency and collaboration between stakeholders has often led to adversarial relationships.
9:36
There we go.
9:40
These issues were in their extreme back in 1996, and I began to review many of the medical necessity documents that were out there to try to understand some of their best qualities as well as their weaknesses.
9:56
And this led to the formulation of some principles that would guide the development of a value management tool that could help unify our field.
10:06
And these are the principles that we came up with.
10:09
First of all, there should be dimensional ratings that are quantifiable, interactive, and dynamic.
10:16
The tool should be easy to use and understand, not based on diagnosis, which is notoriously inaccurate and of limited relevance to these kinds of decisions.
10:30
We would want something that is would facilitate collaboration and empowerment of service users and providers.
10:39
And we would like something that would be adaptable to a variety of circumstances and systems to break down again the fragmentation that we currently encounter.
10:52
And we'd obviously also would want reliable and effective recommendations.
11:07
So with these principles in mind, I began to design Locus along with my AACP colleagues, and we ended up with a tool that's intuitive, easily accessible, which takes a unique approach to defining service intensity, and is easily adapted to computerized assistance and reaching service intensity recommendations.
11:30
Its simplicity helps to promote recovery oriented care and guidance for treatment planning, and it helps us find the right balance between quality outcomes and cost consciousness.
11:49
So I'm just going to give you a brief description of the tool itself in case some of you are not familiar with it.
11:55
The Locus rating system uses 6 dimensions.
12:00
Risk of harm includes both intentional and unintentional risks associated with various illnesses.
12:08
Functional status includes indicators related to interpersonal interactions.
12:14
Ability to accept and carry out responsibilities and physical function such as sleep disturbance, appetite or energy changes.
12:25
The third dimension is comorbidity and that considers illnesses that coexist with the chief complaint and their interaction with that condition.
12:37
The recovery environment has 2 sub scales, one for stress and one for support.
12:45
Treatment and recovery History is 1 skill that considers past responses to treatment rather than a here and now assessment and recent responses are most heavily weighed.
12:57
Finally, engagement and recovery status.
13:00
How does a person relate to treatment and to what degree do they understand their situation and take responsibility for change?
13:22
There we go.
13:23
I'm having trouble getting these too advanced.
13:25
Anyway, the locus has a 5 point rating scale in each dimension, and each numeric rating has several indicators for the rater.
13:41
Raters are instructed to select the highest numeric rating in each dimension in which at least one of the indicator fits well.
13:48
For the presenting condition.
13:51
The indicators won't always be an exact fit, so in that case raters should choose the closest fit, and if there's uncertainty between two numeric ratings, raters should choose the higher rating and error toward the side of caution.
14:09
The seven ratings, including the two ratings in dimension 4, are tallied to obtain a composite score.
14:21
So the composite scores are correlated with the defined levels of care, which I'm going to say a little bit more about in a minute, but they're not the only measure needed for a level of care recommendation.
14:34
Locus always also defines some independent criteria which can override the composite score in some circumstances.
14:42
So high scores of four to five in any of the first 3 dimensions indicate a need for a secure environment with close monitoring.
14:52
So, for example, if somebody is acutely suicidal, they should be admitted to a highly supported environment regardless of low scores and other dimensions.
15:07
So as I mentioned earlier, LOCUS defines levels of care uniquely.
15:17
Basic services in the community do don't constitute a level of care, but they are important to have in place.
15:24
These are prevention and crisis services that are that all healthy communities should provide and should be available to all regardless of their circumstances.
15:35
So places like libraries, churches, schools, places of employment, recreational facilities, and primary care centers all may be involved in identifying people who need assistance.
15:50
The six levels of care in locusts are named in the following way.
15:55
Level 1 is recovery, maintenance and health management and this is really a graduate level of care for people who are stepping down for more intensive services and may need occasional check insurance to maintain their health.
16:10
Level 2 services are community based periodic visits, similar to most outpatient clinics.
16:20
Level 3 services are also community based but more intensive, usually a few visits each week.
16:27
Level 4 services can serve people able to live in the community but who require intensive treatment and support, such as partial hospital programs or intensive community support programs such as ACT.
16:43
Level 5 services are for people who require a safe, closely monitored setting, usually out of the home, and who also have needs for intensive clinical care.
16:56
And Level 6 is the most intensive and the most secure level of care.
17:02
These are usually locked facilities that can serve that can care for people with acute illness or long term functional deficits.
17:18
The locust levels of care are unique in that they are defined by elements of service services available in four categories.
17:26
So there's the care environment, clinical services, support services, and crisis and prevention services.
17:36
The Service plan can be constructed by selecting from a menu of all of those elements available in their locality.
17:44
So these elements may overlap in some cases, especially with regard to support and prevention services, and this provides A seamless continuum and flexibility for individualizing the Service plan.
18:00
The cost of care is related to the intensity of the level.
18:04
The cost may vary from individual to individual depending on their need, but on average, the cost of care will be consistently related to the level of care and this can be helpful for creating progressive reimbursement arrangements that can reduce the frequency of reviews and the administrative expense associated with those.
18:35
So this slide just lays out the types of services that should be available at each level of care to some degree, the type of facility, the intensity of medical involvement, the availability of other staffing and the care that they provide along with other supports and health promoting activities.
19:00
So we often think of Locus as a value management tool.
19:04
It helps us, helps give us give us the biggest bang for our buck in the following ways.
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It's simple and intuitive, accessible to all stakeholders.
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It provides an efficient clinical platform that can be used from initial assessment to treatment planning, progress documentation and transition plan, and it can follow the client along the course of their care as they make transitions through the continuum of services.
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It reduces recidivism by considering both acute and longer term needs.
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It's participatory and promotes person centered recovery oriented care resulting in client investment and empowerment along with stronger therapeutic alliances.
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It allows simple pathways to individualized treatment planning in a continuum that is flexible and adaptable, and can also reduce bias in structural discrimination in that it allows us to be consistent in the things that we consider in making these decisions.
20:22
And so in the end, a more efficient workflow allows more resources going to services rather than paperwork.
20:30
And this will be important in meeting the increasing needs that we're experiencing right now.
20:39
So in summary, Locust has advantages for all stakeholders.
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Clinicians benefit from more streamlined documentation and treatment planning in collaboration with their clients, building their relationship and investment in treatment.
21:00
A common and consistent language that reduces redundancy, paperwork and fragmentation.
21:07
Payers are going to benefit from better outcomes resulting from the right amount of service.
21:14
Greater delegation to providers will reduce costs, and data collection will allow for more appropriate planning for systems needs.
21:23
Simplified payment arrangements will also reduce administrative costs and allow the extension of services.
21:32
Service users are going to benefit from opportunities to participate in their assessment and service planning with accessible accounting of their needs.
21:44
Their investment in their care will make adherence easier and they'll have the opportunity to see the quantification of their progress.
21:53
And they're also going to benefit from greater equity and resources.
21:59
And finally, the public will also benefit more equity, value, prevention, transparency, all kind of equal better health.
22:11
And so I'm going to end there and turn things back to Laura.
22:17
Thanks, Doctor Sowers.
22:19
So now that we've heard sort of about this tool and how it works and what it can do in terms of helping patients may be managed across the continuum of care, I want to talk a little bit about integrating Locus into the, UM workflow through a tool called the Locus Navigator.
22:41
So the partnership Optum approached the AACP to really form a new partnership.
22:47
We kept hearing from our client base that people are functioning in multiple workflows.
22:53
Although Locust was a computerized assessment, it was not inside the UM workflows that the payer organizations and provider organizations were using to do their day-to-day work for the function of utilization management.
23:08
So that created a lot of inefficiency, alt tabbing out to other systems, not having a central place where all sort of the data is ultimately collected and what is happening with your your patient, your member population.
23:21
You also have, you know, many States and the accreditation standards that require a use of an interator reliability tool.
23:28
So organizations such as NCQA and URAC, those tools are tools that make sure whether I'm doing the review or Doctor Sowers is doing the review, we come up with the same answer for that clinical situation for that patient or member.
23:41
And that didn't exist.
23:43
And so in some states, it's required by state law.
23:45
And that leaves the payer organization to create their own, which takes time, administrative burden and costs money to do that and keep it up.
23:55
So the Locus Navigator, what that does is it embeds the actual locus assessment directly into that interfol workflow and helps eliminate all those workarounds so that you've got efficient and consistent compliant reviews in what you're doing and also provides that integrator reliability testing tool that helps reduce those discrepancies.
24:16
And it really checks and monitors of do you understand the overall process and can you actually apply?
24:21
And I'll talk in a few minutes a little bit about that.
24:24
You know, Optum is the only Optum is the one that is integrating this right now into AUM workflow through our exclusive partnership with AACP and Deerfield Solutions.
24:33
Deerfield Solutions provides a software program, but it's external to the, UM, workflows that happened today.
24:41
So what does the Locus Navigator do?
24:43
I mean it's streamlining that whole process into one workflow seamlessly.
24:48
It's just another content module that is on your registry of all the different things that the current marketplace is licensing.
24:55
So organizations have kind of a one stop shop, if you will, to be able to license this tool and have it be available in their both their internal workflows in their provider portals, if they'd like to do that to enable that content to be fire enabled FHIR, the fast healthcare intraoperative resources, which is very much coming the banner of CM s s regulation OF0057 starting 1127.
25:24
That content from a payer perspective must be the criteria must be interoperable and to do that it must be formed in the fired standard.
25:33
We offer that through the optimum solutions that automatically takes the Locus A tool and converts it into the fire based format, obviously improve the consistency and accuracy of what you're doing.
25:45
So if you've got this guided workflow assessment that's driving you in an algorithmic rules based way, you've got a fair and unbiased application of the Locus assessment and it's certainly supporting your level of care determinations to be consistent from individual to individual who may be doing those, whether that's a provider submitting it in a portal or a provider submitting something that a payer then is reviewing, such as the medical record or even the payer having access into the electronic health record of the behavioral Health Organization that, for example, might be asking for residential treatment or partial hospital also reduces discrepancies and supports the accreditation process.
26:25
So as I mentioned earlier, the integrator reliability tool is required by these accrediting bodies and CQA, URAC and some state individual regulations for the payer organizations.
26:37
And there are also additional, we'll talk about in a second training courses that are available from the AACP through our tools.
26:46
So what does this look like on the left?
26:47
You see you've got sort of a medical review and you're simply being driven through a the questions kind of one at a time cycling through driving you to ultimately a recommendation in the locus framework.
27:01
This tool is the locus criteria.
27:03
So it is no different than what one would use if they were using it outside our system stand alone.
27:09
And we take into account what was the level of care that was being requested and what did the Locus tool suggest is the appropriate level of care.
27:18
So you have a understanding of it's not that the patient needs no care, it's here's the most appropriate level of care according to the Locus tool.
27:27
And if those two things match what was requested and what locus recommends, great.
27:31
If not, then you've got a level of care that is being recommended.
27:35
And then that is again a screening tool.
27:38
So it would then go up to a medical director level of review with the information from the Locus tool for a peer-to-peer kind of conversation about what is really needed for this particular member.
27:51
So we include with the Locus Navigator, the Locus Tool itself, the intraday reliability testing tool.
27:57
And then we also are highly recommended and have implanted in our learning management system or LMS, the following, if you will, sessions that the AACP has created.
28:10
So these are created by the AACP.
28:12
They are asynchronous.
28:14
We have the Locus certification training, which is basic foundational support of new users to the tool.
28:20
How do you use it?
28:21
How do you apply it?
28:22
We have a Locus refresher testing, so that is really somebody who's looking for additional training after they have their initial certification can also be used when you notice in your inter rater reliability that a particular staff member might be struggling in an area.
28:38
And what's great about the inter rater reliability tool is it is built with adult education specialists who then can pinpoint this is the area that the individual doesn't really understand.
28:50
So that if you were to go to a refresher training, you've got the training to help that person get back on track and really understand like kind of where they were going Askew in their understanding of the tool.
29:00
And then there's the Locust supplementary training, which is a vignette based series.
29:04
So it's for more seasoned locust users.
29:07
I mean, we always have recommended that somebody use any one of our tools at least for three months before they would take an intra reliability testing to ensure that they've, you know, gotten their trainings, gotten their feet wet and have started doing reviews, have their feedback with their supervisor and then can figure out do they need additional education.
29:29
So in summary, really I think between our partnership with the AACP and what we've provided from a software perspective, along with the intra reliability, along with the training available, you have a consistent compliance with UM, in, UM, with Locus, right?
29:47
So we've got that continued drum beat of rising regulatory mental health parity scrutiny that's going on out there.
29:53
You've got Locus giving a common language across the marketplace for reliable Orient, you know, recovery oriented type work that can happen with with our members and our patients and leverage the entire continuum.
30:07
The WIC decision is still out there regarding generally accepted standards of care.
30:12
So we've got Medicaid being mandating locust use of locusts in 26 states plus DC.
30:20
We also have the ability to create FIRE enabled, if you will, FHIR enabled for interop.
30:26
So compliance with CMS 0057, which will be starting 1127.
30:31
And certainly the standardized application is just creating value across the ecosystems.
30:35
You've got kind of better clinician member outcomes, simpler payer administration for what you're doing and then you know greater transparency in terms of the marketplace and and what's available there.
30:48
So with that, we'd like to go to some Q&A.
30:51
Lisa or Amanda, wondering if we've got some questions in the queue out there for us.
30:59
Yes, thank you.
31:00
At the time, we're going to address some questions that came in during the presentation.
31:06
The first question is, is the locust navigator completely consistent with the locust criteria from the compliance perspective with any particular state or federal mandate?
31:20
Sure.
31:21
The answer is clear, yes.
31:23
And and Doctor Sowers can sort of validate that we have done nothing from the Optum or the intercalled intercalled Connect tool to vary in any way, shape or form.
31:34
We work directly with the AACP after the integration of the tool into our workflow and validated that they signed off that it's it is the locus tool, it works correctly.
31:45
The algorithmic scoring works correctly.
31:47
So it is the locus criteria and all of its mechanisms for scoring are correct.
31:56
Absolutely.
31:59
West wouldn't allow it any other way.
32:04
Yeah, AATP has a certification process that, you know, we want to make sure that any software versions of the tool are accurate and give the proper responses.
32:17
And so the we have passed this version with flying colors.
32:27
OK, great.
32:28
And then our next question is, why is it only Optum that integrates the locus assessment with UM workflows?
32:39
So we have partnered with the AACP to build that relationship and have I think demonstrated from a utilization management perspective, this was a great way to be able to get it to the market.
32:53
We're able to service anybody in the market regardless of of what anybody uses of their own policy of their own different UM systems again, because it's embedded inside a API available fire enabled environment to get that to market.
33:19
OK.
33:19
Other questions, Our next question is, does the Locust navigator identify when there is a disconnect from the level of care requested and the level of care being recommended?
33:34
It does.
33:35
So that's what I mentioned probably in the in this slide, I think right here I can bring back up.
33:44
So you can see the over here on the right hand side, the recommended level of care here, Level 3 high intensity community based services versus what was actually requested to determine if they match, right.
34:00
So if they match, then the criteria are met.
34:02
So if you're asking if this particular organization was asking for authorization for a level 4 type services and Level 3 is what's met, then the criteria are not met.
34:14
If they if they matched in this case they do the criteria as you see in this box would be met and they could services could be approved and you know, you move on to the next next time at which that patient might need to be assessed or reassessed.
34:33
OK, yeah.
34:34
You know, there's, there's a number of situations I think in which, you know, the requested level of care is not in tune exactly.
34:45
But locusts would recommend, you know, there are a number of reasons that people might diverge from a recommendation.
34:54
And you know, I think what we like to see is, you know, if there is a divergent that there'll be some rationale for, you know, kind of that decision.
35:09
It's a little bit different than what we were talking about here, but I think that that's something that we always keep in mind that, you know, the level of care recommendations are that there are recommendations and there are some situations in which either by client preference or other circumstances, the recommended level of care is not something that is reasonable for a particular individual.
35:40
So we we try to respect that as well.
35:44
And we've heard that certainly doctor sours in the marketplace.
35:47
You know, a great example of that is, you know, a mother, single parent who really maybe needs residential treatment services would be the best option for that person.
35:58
She has no one to care for her children and she wants care.
36:02
So how do you do that and how do you think about that in this framework to get that patient at least some services to help them start on their their way to recovery?
36:12
I heard that one a lot.
36:14
Yeah.
36:17
Thank you both.
36:19
The next question is can you speak more about the IRR tool you developed together and how it helps ensure consistent application of the locus assessments?
36:32
Sure, I can start.
36:33
And then Dr.
36:34
Sowers can, you know, kind of he was directly involved with this so he he can talk about his side.
36:40
So from an inner inter reliability kind of perspective, we take a overarching approach to that, whether it's a tool for Locus or one of the other Interpol modules or the ASAM module or any of them.
36:52
And that is kind of a two-part test, if you will.
36:55
The first part of it is really testing.
36:57
Do you understand how this particular module, content module, how it works?
37:02
You know what it is, as Wes explained, the different dimensions, the different levels of care, the scoring system, you know, do you have a basic conceptual framework of how that works?
37:12
And Part 2 are actual clinical vignettes.
37:15
So can you show me that you can actually use the tool and come up with the correct answer?
37:21
And so all vignettes came through the AACP.
37:24
We work with them very closely, as well as their look at and validating the tool.
37:29
So I don't know, Doctor Sowers, if you want to say more about your involvement in the development of the IRR tool.
37:36
Yeah.
37:36
You know, I, I think you described it pretty well, Laura.
37:39
The the, yeah, I think the, the thing that's really nice about this tool is that it's really designed to help educate people at the same time as, you know, kind of looking at their level of competence.
37:58
You know, obviously, you know, we would like to see everybody who's gone through the training do very well.
38:04
And I think they will for the most part.
38:07
But you know, it's also an opportunity to really identify folks that may be struggling or have a misconception in some particular area of its application.
38:20
And so, you know, the vignettes are designed to, you know, kind of have a practical application of the tool and see where, if any place things breakdown in terms of somebody making a rating.
38:39
And so for each item, there's a there's an explanation it's given for the for the recommended answer and an opportunity for people to really learn in, in being involved in that process.
39:00
All right, thank you for our next question.
39:05
It's are the training tools loaded in the IQ Learning source site yet?
39:12
Yes, the tools are are there.
39:14
And so people who licensed the Locust Navigator would then have access would work in through our training group to get their access to those particular modules.
39:30
OK, great.
39:32
Do you think other criteria vendors are accurately representing the locus assessments within the, UM, workflow?
39:44
Doctor Sowers, you want to take that one?
39:46
Sure, yeah.
39:48
You know, I think we've we've become aware that some other vendors are representing that their medical necessity criteria are consistent with Locus and that's actually a misrepresentation for the most part that that many of those.
40:12
Assertions are made without substantiation and without consultation with the AACP.
40:20
And so, you know, we're very wary of those kinds of claims unless there is, you know, some evidence that they have actually consulted with us and that we have approved whatever kind of algorithm that they have developed.
40:39
So, yeah, so we we're very wary of that and and we hope others will be as well in terms of accepting those those kinds of assertions.
40:56
And then our next question, when the Locus criteria is updated with the navigator to be updated, will the navigator be updated as well and what is the typical roll out time?
41:12
Sure.
41:12
So I can start with certainly any, any updates that AACP will do to Locus, we would be in close partnership with them.
41:22
We meet in a monthly cadence for governance call and understand like where they're at in terms of their future versions.
41:30
And we would have some lead head time to be able to know what that is when the the tool is finalized for any update and then we would incorporate it.
41:39
And so we have the ability to push a release as frequently as the first Friday of every month.
41:43
We do that for our Medicare navigators and our Medicaid navigators today and would certainly, you know, have those windows to to update it.
41:51
So I don't think the length of time would be very long from the release of the next version of Locust into because I think we'll have that head time in the close partnership as well as that window of opportunity to update the software pretty frequently every first Friday of the month.
42:11
Doctor Sowers, anything else to say there?
42:12
Would maybe talk a little bit about what you guys are thinking about in terms of next version?
42:17
Yeah, I, I didn't hear the last part of the question.
42:21
Could you repeat that?
42:26
Yeah, they said would the navigator, will the navigator be updated as well?
42:32
And what is the typical rollout time?
42:36
What is the, I'm sorry again, I didn't quite get it.
42:39
What is the typical rollout time?
42:44
Oh, OK.
42:44
So that's the software was I think they're asking, you know, when the locus criteria is updated.
42:49
So did you want to address the updating of the, you know kind of where your your mind is at from the C PS perspective on that?
42:58
Yeah, you know the we're currently working on a revision that we expect to be ready within a year or so.
43:08
But you know, the locus criteria been pretty stable over the course of time.
43:13
We don't envision frequent updates.
43:19
So I think that once we are ready to release, but will be Locus 30, you know, it shouldn't take long to do those updates.
43:31
And there's there's some changes I think in terms of clarification of some of the indicators for specific ratings and in the language around the descriptions of levels of care.
43:48
I think those things will be coming, but it it won't be a major departure from Locust 20 and those updates should be relatively easy to make.
44:00
And so we wouldn't think that the the time for roll out of the new edition would be extended for any significant period of time.
44:17
OK.
44:17
And what seems to be our last question is Doctor Sowers, how would you describe your partnership and collaboration with the Inter Club team to date?
44:28
Terrible.
44:29
No, I'm just kidding.
44:31
I have my test one on to let it slide off.
44:35
No, you know, it's, it's been great.
44:37
We've, I think, been very pleasantly surprised by this partnership and been impressed by, you know, Intercall's commitment to this project and their commitment to, you know, promoting the value of services that we provide.
44:59
You know, and it's, it's really important because I think, you know, obviously, as I said, in the past, there has been some friction between, you know, payers and providers and, and, you know, the, one of the main purposes of Locus has been to reduce that friction and to get people on the same page.
45:24
And so, you know, Intercal's ability to help increase the penetration of locusts and the capacity to, you know, begin to heal some of those old wounds, I think is really important.
45:42
And you know, what we, what we really envision is, you know, a world in which everybody's on the same page and working towards the same objectives.
45:56
And I think, you know, Locust was certainly designed to do that.
46:01
And so I think our relationship with Inner Qual and kind of getting it out there and increasing its accessibility is really wonderful.
46:13
And we've, we've had a great partnership and I really enjoyed working together.
46:20
So it's been great.
46:25
Thanks, great.
46:29
Thank you to our speakers.
46:32
I want to thank you for that great presentation and for sharing your thoughts.
46:37
Thank you to the audience for participating in today's webinar.
46:40
And this concludes today's presentation.
46:43
Thank you again and enjoy the rest of your day.
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