Managed Care & Value-Based Reimbursement
The impending shift to value-based reimbursement (VBR) and managed care in the health and human services industry has become a driving force across both public and private sector organizations, not only forcing new operating models and systems, but pushing providers to develop new partnerships with payers and to prepare for population health management. This shift presents organizational, technical, and cultural challenges that require a robust technology infrastructure, data-driven decisionmaking, and new leadership competencies. As behavioral health provider organizations move towards risk-based contracts, those who adapt to this change will have a better opportunity to carry forward in the provision of value-based services.
Editor’s Picks
- Rhode Island Rebids Medicaid Managed Care Services
- Molina Misses Readiness Review Deadline For Indiana Medicaid Managed Long-Term Care Contract
- Medicaid MCO Prior Authorization Denial Rates Double Medicare Advantage Denials; MACPAC Recommends Changes To State & Federal Oversight
- Wisconsin Medicaid Rebids Family Care LTSS Programs For Consolidating South-Central Region
Latest Resources
- Making Primary Care Work
- Texas Seeks STAR Kids Managed Care Services
- Pennsylvania Seeks Enrollment Assistance Program Services For The HealthChoices Physical Health Program & Children’s Health Insurance Program
- The Changing Health Plan Perspective
- Illinois’ Cook County Seeks CountyCare Comprehensive Housing Services & Support
- Iowa Seeks Medicaid Health Link Services
- Florida Medicaid Awards I/DD Managed Care Pilot Contract To Florida Community Care
- What Do Health Plans Want In 2024? Health Equity, Analytics Maturity & Care Delivery Innovation
- Roadmap For Implementing Value-Based Payments
- West Virginia Seeks Managed Care Enrollment Broker Services
- North Carolina Seeks Medicaid Children & Families Specialty Plan Services
- The Homeless Solution Opportunity
- Carelon Behavioral Health, Inc. – Winning Proposal & Contract For Mobile Crisis Administrative Services Organization To Kentucky Cabinet For Health & Family Services, Department For Medicaid Services, 2023
- Pennsylvania Seeks Community HealthChoices Services
- WellBe Senior Medical Secures Investment From CVS Health Ventures To Accelerate Nationwide Expansion
CVS Health Ventures, the corporate venture capital arm of CVS Health, invested in WellBe Senior Medical, which provides home-based medical care for Medicare Advantage members. The amount of the investment was not disclosed. WellBe plans to use the investment to fund national expansion of its value-based home care model. WellBe currently has operations in seven states, and serves more than 107,000 Medicare Advantage members. The company partners with Medicare Advantage health plans via global capitated… Read
- Follow The Money: Notable 2023 Health & Human Service Government Contract Awards
- Performance Leads The Pack: The Most Read 2023 OPEN MINDS Reports
- Washington Medicaid Integrated Medical & Behavioral MCOs Fail to Outperform Carve-Outs in Behavioral Health Access In First 2 Years
- Wisconsin Seeks Managed Care Organization For The Delivery Of Managed Long-Term Care In GSR 5
- Innovating For Impact: OPEN MINDS Most Watched 2023 Executive Institute Presentations
Latest Industry Bulletins
- Florida Medicaid Awards I/DD Managed Care Pilot Contract To Florida Community Care
- WellBe Senior Medical Secures Investment From CVS Health Ventures To Accelerate Nationwide Expansion
- Equality Health Joins Accountable For Health To Speed Transition To Accountable Care
- Alera Health & Affiliated Network Providers Enters Value-Based Agreement With Mercy Care In Phoenix, Arizona
Latest Industry News
- Washington Medicaid Integrated Medical & Behavioral MCOs Fail to Outperform Carve-Outs in Behavioral Health Access In First 2 Years
- Increases In Value-Based Payment Adoption Decreased Burnout Among Primary Care Physicians
- Michigan Rebids Medicaid Managed Care Contracts For 2024 To Implement MIHealthyLife Initiative
- Washington State Purchasers Align To Support State’s Participation In CMS Making Care Primary Model
- Headspace Joins Castell’s Value-Based Network As First Digital Mental Health Platform