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OPEN MINDS Management Newsletter

The Financing & Reimbursement Issue


Follow The Money: The Golden Rule Of Health & Human Services

The OPEN MINDS Mapping The Market Series
Moving Beyond Fee-For-Service




Askesis Development Group, EHR, Technology


Follow The Money: The Golden Rule Of Health & Human Services

Cover Story | Monica E. Oss, Chief Executive Officer, OPEN MINDS

Our January issue is focused on “the money” – current spending in specific niches of health and human services and how financing and reimbursement models are changing how those financial resources reach the consumers who are receiving services. You will find a...

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Mapping The Market: How The Size Of The Health & Human Service Delivery Market Impacts Provider Organizations

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

The health and human service market is a complex web of public and private funding where each payer has its own intricate, sometimes contradictory, set of rules. Even when a provider organization has a good understanding of what it costs them to deliver a service...

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Mapping The Mental Health Market: 45 Million Adults With Mental Health Issues & $113 Billion In Annual Spending

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

In 2005, the Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that national spending on mental health treatment totaled $113 billion. Of that total, public payers accounted for the majority (59%) of the total...

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Mapping The Addiction Treatment Market: 20.6 Million With Substance Abuse Issues & $23 Billion In Annual Spending

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

In 2005, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), spending on addiction treatment in the United States totaled $22 billion. Public payers accounted for the vast majority of spending (79%) at $18 billion...

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Mapping The Child Welfare Market: 5.9 Million Children In Contact With Child Welfare System & $29.3 Billion In Annual Spending

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

In 2010, according to Child Trends, total funding in support of child welfare services was roughly $29.3 billion in combined federal, state, and local funds. Federal funding in support of child welfare services was $13.5 billion in 2010, and included $1 billion...

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Mapping The Developmental Disability Market: Over A Half-Million People With Disabilities & $53 Billion In Annual Spending

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

In 2009, public spending on developmental disability programs (DD or I/DD) totaled $53.21 billion for DD services and income maintenance, according to analysis by the University of Colorado. Of the total, 58% ($30.6 billion) was spent on DD disability...

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Mapping The Social Services Market: 100 Million Receive Social Support & $375 Billion In Annual Spending

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

In 2007, social support spending total $375.3 billion in the United States, according to the Rockefeller Institute of Government. The majority of the spending came from federal funds passed down to state and local public agencies through intergovernmental...

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Mapping The Chronic Disease Management Market: 73.6 Million People Enrolled & $2.8 Billion In Annual Revenue

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

In 2010, spending on disease management services totaled $2.8 billion, according to The Disease Management Purchasing Consortium. Of those individuals receiving care, 18.7 million (25.4%) are in disease management programs targeting behavioral...

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Mapping The Juvenile Justice Market: 71,000 Youth In Custody & $6.4 Billion In Annual Spending

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

In 2010, federal and state spending on juvenile justice totaled $6.4 billion, with state spending comprising the majority at 96%. The American Correctional Association reports that the per diem costs of placing one youth in a juvenile facility...

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Mapping The Adult Corrections Market: 6.98 Million People In Corrections System & $81 Billion In Annual Spending

Industry Analysis | By Laura L. Morgan, Market Intelligence Manager, OPEN MINDS

In 2010, according to The Bureau of Justice Statistics, spending on adult corrections in the United States totaled $81.5 billion. Of that total, 8% was in federal spending; the federal government spent $6.2 billion on the federal prison system in 2010...

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Risk-Based Financing Models On The Rise: What Are Your State’s Plans For 2013?

Executive Briefing | By Monica E. Oss, Chief Executive Officer, OPEN MINDS & Sarah C. Threnhauser, Executive Vice President, OPEN MINDS

States made it eminently clear in 2012 that the use of risk-based financing models is here to stay – 40 states have expanded their use of managed care to manage Medicaid and 18 states opted to utilize some form of capitated payment for their integrated...

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Trends In Managed Care Contracting: 2001–2010

Industry Feature | By Embry Howell, Ashley Palmer, and Fiona Adams

Over the first decade of the 21st century, the role of risk-based managed health care for publicly insured beneficiaries has expanded substantially. This report examines this form of health care delivery in 20 states for both Medicaid and CHIP nonelderly adults and...

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Goodbye FFS, Hello Risk: How To Successfully Operate Under A Managed Care Contract

From The Expert | By Monica E. Oss, Chief Executive Officer, OPEN MINDS

Managed care continues as a primary disruptive influence in today’s health care industry. Provider organizations need to be prepared to replace the outdated modes of managing funding streams in the traditional fee-for-service...

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Understanding The “Risk” In An “At Risk” Contract

From The Expert | By Monica E. Oss, Chief Executive Officer, OPEN MINDS

The "more is better" thinking that has traditionally dominated the health and human service field is slowly, but surely, diminishing. I recently read a great take on the pressures facing health and human service managers in a great Q&A the former...

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© 2012 OPEN MINDS, Behavioral Health Industry News, Inc. All rights reserved.