April 16, 2012
Greetings from the Windy City! I’m in Chicago at the National Council Mental Health and Addictions Conference, and have enjoyed catching up with colleagues old and new. Our team – John Talbot, Ph.D., Daniel Y. Patterson, M.D., and myself – helped to kick off this year’s conference with a preconference university, Beyond FFS: Like It or Not, Performance-based Reimbursement Is Your Future all members.
We spent the day with 100+ executives from all over the country puzzling over the recent developments in performance-based contracting and alternative payment models. The day had four big themes…
Health care system market segmentation is changing. We are moving from segmentation by professional specialty to segmentation based on consumer resource utilization and support needs (see The Marketing Challenge Of The 5% & The 95% all members and 5% of U.S. Residents Use 50% of Medical Resources all members).
Managed care enrollments are up. For the short-term, the use of traditional FFS-based managed care is on the increase – this is particularly true for high-cost populations (see “Managed Behavioral Care” Evolves all members and Budgets & Health Care Reform Push Medicaid Managed Care – Are You Ready? all members).
Performance-based contracting is a means to an end. Pay-for-performance will serve as a way to “ease” into the end of FFS and move service provider payments to alternative financing (see The Challenges and Opportunities of Performance-Based Contracting and Medicare Demonstration Project Results Are In – Only Winner Was Bundled Payments all members)..
In non-FFS environments, two management competencies are key. Tech-enabled care management infrastructure is “must have” for getting the real-time data needed to manage case rates and bundled payments. And, a metrics-based management approach is critical to keeping productivity and service utilization metrics in line (see Using Technology To Transform Your Business Model & Preserve Your Mission: Finding The Opportunities In A Changing Health & Human Service System and For Strategic Success, It’s All About Execution all members).
For a deeper dive, take a look at our sessions from Saturday’s preconference:
If you have questions or comments on managing in this new contracting era, please feel free to send them to John, Dan, or me at firstname.lastname@example.org.
Monica E. Oss
Chief Executive Officer, OPEN MINDS
For another free resources, see: Embracing Case Rates To Make Medical Homes A Reality all members
This is free for the next sixty days to all registered OPEN MINDS Circle members.