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.

Latest Resources

• Long-term Enhanced ACO Design (LEAD) Model
• What Is The ‘Value’ Of Health Care?
• VBR Sputter or Surge?
• Who Moved The Medicaid Cheese? A Look At Some Of The Largest 2025 Contract Awards
• Understanding Medicaid Managed Care Procurement Practices Across States
• Medicaid Managed Care Procurements: A Toolkit For State Medicaid Agencies
• Medicaid Managed Care Plan Transitions: A Toolkit For States On Promoting Continuity Of Care When Plans Enter, Leave, Or Merge Or Are Acquired
• The Changing Face of Medicaid Managed Care: The Most Downloaded OPEN MINDS RFPs Of 2025
• Rewriting The County Playbook
• The State Of It All
• The Tech Of Aging
• The State I/DD Challenge
• Child First & Center
• Data-Driven Whole Person Care
• VBR Momentum

Arizona Medicaid Contract For Elderly/Disabled Members Changed After Protest

On May 2, 2025, the Arizona Health Care Cost Containment System (AHCCCS) announced it had entered a settlement agreement and awarded four contracts for the Arizona Long Term Care System-Elderly and/or Physically Disabled (ALTCS-EPD) program. The settlement agreement resolves a procurement protest. The awardees are Arizona Physicians IPA, Inc. (dba UnitedHealthcare Community Plan); Banner-University Care Advantage (dba Banner-University Family Care); Mercy Care, and Bridgeway Health Solutions of Arizona, Inc. (dba Arizona Complete Health-Long Term Care).… Read

• Blue Cross & Blue Shield Of North Carolina – Winning Proposal & Contract For Medicaid Children & Families Specialty Plan Services To North Carolina Department Of Health & Human Services, 2024
• 64% Of Health Care Organizations Expect Increased Value-Based Care Adoption
• The Medicaid Question
• Measuring Outcomes In Whole Person Care
• Another Step Forward

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