PERFORMANCE OUTCOME MANAGEMENT SYSTEM (POMS) INITIAL CONSUMER REGISTRATION
The primary purpose of the POMS data collection is to serve as the basis for producing a set of performance measures/indicators for the BH-MCOs. The POMS serves the following functions:
- Provides accountability for public funds expended through the Department’s capitation payments to the BH-MCO contractors.
- Provides a fair and objective evaluation of the BH-MCOs that the Department can use for implementing outcome oriented incentives and sanctions.
- Supports the Department and the BH-MCO contractors to implement a collaborative Continuous Quality Improvement process.
- Provides outcome data to support the necessity and validity of the behavioral health carve-out.
Providers are required to report to Carelon data about psychiatric consumers in the HealthChoices program electronically through ProviderConnect. ProviderConnect is available online at pa.carelon.com/providers.
For completion of the POMS data reporting, please follow these instructions:
- Submitting POMS through ProviderConnect pertains to Mental Health Services only. If you are providing services as a licensed Drug & Alcohol provider, please refer to the Bureau of Drug & Alcohol Programs process for POMS reporting.
- If you are providing services as an inpatient provider, Carelon will complete POMS reporting as part of the assessment process.
Instructions for submitting POMS through ProviderConnect has been developed to answer your questions regarding the POMS reporting. If you need further assistance, please call the toll-free provider line at 877-615-8503 and someone will assist you.