Greetings from Florida, where today we hosted a group of executives from intellectual/developmental disability (I/DD) provider organizations from across the county for our inaugural OPEN MINDS I/DD Executive Summit. The day focused on the many changes and challenges we’re seeing in the I/DD market — the move to value-based care, the shift away from residential treatment, the increasing emphasis on consumer-directed care, and new workforce challenges.
In many ways, the I/DD market hasn’t evolved as quickly as the physical health, behavioral health, and children’s services market. We’ve seen the slow shift of behavioral health and children’s services to managed care, coupled with a move towards more home- and community-based services. These market changes have not fully made their way into the I/DD market — yet.
The push towards more community-based, value-driven models of care has created a need for more clinical treatment technologies, as well as the use of data and analytics. The real question is, are I/DD provider organizations prepared to implement these technologies? My answer, based on today’s discussions, is that the market is moving in the right direction, but we’re not there yet.
We discussed this question today in the panel discussion, “Technology Considerations For Managing Performance In The Move To Value-Based Payments.” The conversation featured Matt Pettinelli, president and CEO of CapGrow Partners; Tom Haglund, chief financial officer of Rise Inc.; Jeff Cross, president of Public Solutions at Benchmark Human Services; and Shannon MacKenzie, CDP, area manager of HealthStar Home Health.
To understand why there is a lag in technology adoption, Mr. Cross outlined some of the issues that limit the adoption of new technologies among I/DD provider organizations, particularly those with Medicaid as their primary payer. Some of the key issues limiting the adoption of technology that stood out to me include:
- Process vs. Outcome Driven Regulations: In the I/DD market, most Medicaid payers are focused on policy and regulatory compliance and critical incident avoidance, not outcomes. The current fee-for-service (FFS) reimbursement structure provides no financial incentives to encourage the use of data or treatment technologies.
- Limited Integration & Care Coordination: The I/DD population is typically siloed in the health and human service market. Services and supports for this population are often segmented separately from the population with other physical and behavioral health needs, without a robust, integrated case management system — especially for more complex consumers with co-occurring disorders. Without this integration, there is no motivation to share data with other organizations or manage performance through population health management.
- Cost Controls Don’t Focus On Value: In the current FFS structure, the only ways to reduce costs are through limiting eligibility, limiting service units, or reducing reimbursement rates. None of these cost-control options push for better outcomes or focus on the quality of life for consumers. In a value-based market, cost savings can come from better care coordination and the use of technologies like remote monitoring and telehealth.
- Lack Of Industry Standards & Benchmarks: Because the I/DD market has been slow in the adoption of technology and analytics, there are no industry standards or benchmarks to gauge progress or help guide provider organizations. This cycle holds back many of those organizations, giving them no place to start when approaching health plans with new partnership opportunities.
In spite of these challenges, the gradual shift towards value-based care is pushing many provider organizations to consider how to incorporate new technologies and information systems. Which tech competencies should I/DD provider organizations consider in order to adapt to the changing market?
- Electronic record systems that allow for tracking of consumer demographics
- Integrated electronic timekeeping, scheduling, and service-unit billing
- Behavior and incident data tracking, trending, and analysis
- Data-based outcomes measurement that goes beyond consumer surveys
As I/DD provider organizations look towards the future, the use of data and analytics will become key for every organization – now is the time to make investments in the use of technology to assure your strategy for the future.
Couldn’t make it for the event? Check out our coverage on Twitter — #OMIDD. And make your reservations now for our follow-up event, The 2017 OPEN MINDS I/DD Executive Summit, taking place August 15, 2017 in Long Beach, California. Dr. David Braddock, executive director of the Coleman Institute for Cognitive Disabilities at the University of Colorado, will open this event with his keynote address, “Emerging Best Practices In Medicaid Managed Care Long-Term Supports & Services: Trends Shaping The Market.”