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Executive Briefing

VBR & I/DD—The Wave Begins

By Monica E. Oss

Last week, I wrote about the very apt comparison of surfers and executives in health and human services painted by Gus Giraldo, the President of Commercial Markets at Magellan Healthcare, in his keynote address, A Commercial Health Plan’s Perspective”: Magellan’s Philosophy & Approach To Value Based Payment Arrangements, at The 2018 OPEN MINDS Performance Management Institute (see Catching The Wave). He talked about getting ready to ride the “big wave” and the importance of positioning and timing in preparing for the shift to value-based reimbursement. Over the last couple weeks, I’ve been thinking about a different comparison—how waves begin—as I’ve been reading about the initial value-based contracting initiatives between payers and intellectual/developmental disabilities (I/DD) provider organizations. We’ve reported on these developments as they have...

Social impact bonds (also known as pay-for-success or social improvement bonds) are a new way of financing social services that focus on payment for outcomes rather than the volume of services delivered. Under the social impact bond model, private investors put up funding for a social services program, which the government pays back only if the agreed upon performance...
On April 1, 2018, Medicare started covering a performance-based diabetes prevention program. The program is a structured behavioral intervention with the goal of preventing progression to type 2 diabetes in beneficiaries with an indication of prediabetes. The goal is that the participants will implement lifestyle changes and achieve at least 5% weight loss, which will reduce their risk of...

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