Emerging Finance & Service Delivery Models

As selected by the OPEN MINDS Market Intelligence Team

  • How Prepared Are Health & Human Service Provider Organizations For Value-Based Reimbursement?

    Executive Briefing | March 12, 2016
    It’s coming. Over the past couple of months, we’ve covered how all payers are introducing many variants of value-based reimbursement – The Management Transition To Value-Based Reimbursement Is All About The Performance Metrics, Moving To Value – Easy To Say...
  • Moving To Value – Easy To Say & Hard To Do

    Executive Briefing | February 23, 2016
    Greetings from Washington, D.C. and the 2016 Legislative and Policy Conference of the National Association of County Behavioral Health & Development Disability Directors! Yesterday was a power-packed day – with deincarceration of county jails, the development of county-based certified...
  • Dual Eligible Demonstrations: Where Are We 4 Years Later?

    Executive Briefing | February 19, 2016
    The Centers for Medicare and Medicaid Services (CMS) began approving state dual eligible demonstration projects about four years ago, in 2012 – with the first state (Washington) launching its program in July 2013. There are currently nine states with...
  • Is Your Organization Ready To Be ‘The’ Care Coordinator?

    Executive Briefing | February 17, 2016
    The big push in health and human services is to find a provider organization to take on the responsibility for comprehensive care coordination for consumers including some degree of financial risk for the results in terms of consumer outcomes...
  • The Business Model Transition To Value-Based Care

    Executive Briefing | February 12, 2016
    Hello again from sunny Clearwater, where we are wrapping up The 2016 OPEN MINDS Performance Management Institute. It’s been a power-packed three days – with a focus on the evolution of pay-for-performance and value-based contracting. The discussion has left...
  • An Update On The State Medicaid Behavioral Health Carve-Out Landscape

    Executive Briefing | January 8, 2016
    As 2016 begins, we have decided to revisit the ever changing landscape of Medicaid health plan behavioral health carve-outs. There are two big changes in this space: The number of state Medicaid plans with the typical primary behavioral health...
  • The Latest Telehealth Example: Pay-For-Value

    Executive Briefing | December 2, 2015
    Why has telehealth adoption been slow? The market factors are many – low acceptance by clinical professionals, service workflow, integration into clinical recordkeeping systems, loss of traditional revenue streams, licensure requirements, and reimbursement are just a few (see The Telehealth Market – Now,...
  • Reinventing The Carve-Out

    Executive Briefing | September 10, 2015
    In the reinvented world of the health and human services, is there a place for the traditional primary behavioral health carve-out model (see Carve-Out Or No)? According to Brian Wheelan, executive vice president and chief strategy officer for Beacon Health...
  • What Is DSRIP & Why Does It Matter?

    Executive Briefing | November 20, 2015
    Delivery System Reform and Incentive Payment (DSRIP) programs are part of Section 1115 Medicaid waiver safety-net care programs. The program, which operates as a pay-for-performance model, uses a rewards-based payment structure to fund projects focused on meeting the “Triple...
  • Medicare ACOs – A Blueprint For P4P For All Payers?

    Executive Briefing | October 23, 2015
    There has been a lot written about accountable care organizations (ACOs). The concept—groups of primary care providers coordinate care for a specified population with the goal of reducing costs and improving quality of care—was created by the Patient Protection...
  • Emerging Market Models for Behavioral Health & Human Services: Opportunity From A “Big Picture” Perspective

    Industry Resource | March 13, 2010
    This presentation, by Monica E. Oss, Chief Executive Officer, OPEN MINDS, was given at the 2010 OPEN MINDS Marketing and Innovation Institute. During this session, Ms. Oss discussed the shifting market and opportunities, what is driving the current market,...
  • Integration Model Decisions Are Strategy Work At Its Most Fundamental

    Executive Briefing | April 23, 2013
    “Integration” has become a buzzword. While I didn’t say it first (see Dr. Dennis Kodner in Integrated care: meaning, logic, applications, and implications – a discussion paper), I do agree. And, in yesterday’s post, I described the challenges for...
  • Care Coordination Mapping: How Does Care Coordination Vary By Service Delivery Model?

    Market Intelligence Report | December 8, 2013
    No single definition exists for care coordination. The Agency for Healthcare Research and Quality (AHRQ) documented 49 different definitions in use between 1976 and 2006 (see Closing The Quality Gap: A Critical Analysis Of Quality Improvement Strategies, Volume 7...
  • Controlling Coordination = Controlling Referrals

    Executive Briefing | May 9, 2013
    With this briefing, I’m wrapping up this series on the strategic issues around both integrated care management and integrated service delivery. My big picture takeaway: every organization in the field is trying to strategically move to the same place...
  • Great Minds Think Alike

    Executive Briefing | December 18, 2013
    I’m always looking at the trends that shape strategy in health and human services. So when I read the recent FierceHealthcare article, 4 super-sized healthcare trends, with their picks on the mega-trends for 2014, I couldn’t have agreed more....
  • Four Physical/Behavioral Health Integration Models Emerging in State Plans

    News Report | November 14, 2011
    States planning to integrate physical and behavioral health care services can look to four emerging models. The models include integrated care entities operated by managed care organizations (MCO); primary care case management (PCCM) programs; behavioral health organizations (BHO); and...
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