Skip to main content
By Monica E. Oss

What were the big strategic issues for specialty organizations in the health and human service field last year? As I look back on our executive briefings—and look at what topics got the most attention from managers—a few big themes emerged.

Changing reimbursement led the issues list—with lots of attention on pay-for-performance and value-based reimbursement. The changing models for state financing and managing of I/DD services got a lot of traffic. And, where and how Medicaid fits in the picture—for children, for housing supports, for social supports, for peer support services—was another big topic.

I think we’ll see more of these topics in the year ahead—and I expect to add financial sustainability (of every type of organization) and digital health to this list. But we’ll see… for now, in case you missed them, these are our top 2018 OPEN MINDS Circle executive briefings.

Value-Based Reimbursement-The Numbers Are In

Greeting from sunny and warm Florida, and from the first day of The 2018 OPEN MINDS Performance Management Institute. Our institute this year is focused on a timely topic-the tools needed to develop and manage sustainable value-based contracts. I opened the institute with an update …

VBR & I/DD-The Wave Begins

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 …

What’s Holding Up Community-Based I/DD Services?

The push to move consumers needing long-term services and supports (LTSS) out of residential placements and into community settings continues. Part of the push is that there are currently 59 lawsuits related to Olmstead open across the country, which require states to find ways to support care individuals in the community …

High Turnover, The Other Staffing Issue

The average turnover rate among health care workers was 20.6% in 2017, up dramatically from 15.6% in 2010. Health care was second only to hospitality in its turnover (see the Compdata survey. Drilling down by organization type, about 60% of organizations that provided wraparound programs in 2017 had staff turnover …

For I/DD Services, Answering The Value Questions

“You are either at the table or you’re on the menu.” I’ve had that phrase stuck in my head since I presented at the “Shaping the Conversation Around I/DD Services, Quality and Value” symposium in Chicago a few weeks ago at which a group of 24 stakeholders were convened by the Council on Quality and …

Does Peer Support Pay?

Recent research shows the value of peers for individuals with mental illnesses and addictive disorders-that peer support “pays.” Participation in peer support groups for addiction recovery promoted higher satisfaction in treatment and lower relapse rates. And peer support has been found to increase social support and social functioning …

How Does Your State Medicaid Program Stack-Up On Behavioral Health?

The focus on value has created “measurement fatigue” and “outcomes confusion” among managers of health and human service organizations. The problem is straightforward-to pay based on value, you need measures of “performance.” The challenge for most provider organizations is that payers and health plans require …

Hidden Behavioral Health Opportunities In Value-Based Reimbursement

Most executive teams of specialist provider organizations think of value-based reimbursement opportunities in terms of new payment models for their current services-case rates for an acute episode or monthly payments for care coordination. But for any provider organization that has a demonstrated track record in coordinating …

The 5 Key Trends Driving Change In Children’s Services

Last week, we had our first annual OPEN MINDS Children’s Services Executive Summit, and my collaborator and colleague, OPEN MINDS Senior Associate Howard Shiffman and I weren’t quite sure what to expect. We’ve both been working in the children’s services space for a while, and we’ve seen a lot of change. What we found was …

What Will Mental Health Treatment Look Like In The Years Ahead?

What will mental health treatment look like from the consumer perspective in the years ahead? That was the question I addressed at the Cohen Veterans Care Summit yesterday in my session, “The Future Mental Health Care Landscape & Its Likely Effect On Veterans & Families.” I always find it a bit daunting to make …

Paying For Social Services ‘Value’ Requires Measuring Cost Impact

The move to pay for the “value” of health services has brought the issue of social determinants of health (SDH) and the value of social services to the discussion. On a macro-level, while the U.S. spends far more per capita than other industrialized countries on health care, spending on social services is far less. And, the resulting health …

The Future Has Arrived For VBR

“I can’t think of a recent conversation at Anthem that didn’t include value-based care. But, we can’t do value-based payment on an island. All insurance companies are interested in discussing a village concept of value-based care with consumer-centric provider organizations that have the infrastructure to do that. There are …

Medicaid Contract Awards, Waivers, & New Rules-The Top News Stories This Year

We are half way through 2018, and our top news headlines highlight an intense interest in all things Medicaid. So far in the year, a review of the top-read stories shows that executives are focusing on care coordination, data sharing, and home- and community-based waivers-these are the top-15, most-read OPEN MINDS Weekly

What’s The Window To Value-Based Care?

I’m still putting together my thoughts about the transition to value-based reimbursement for the specialty provider organizations serving complex consumers. I went to last week’s event, The 2018 OPEN MINDS Performance Management Institute, not quite sure where we are in the transition process. Our own new survey results …

The Future Of Housing Support

Housing is big news in the health care field these days. On May 18, Kaiser Permanente announced they are investing $200 million in housing projects with a financial return with the goal of being able to support more projects in the future. While the Kaiser Permanente announcement is significant in …

Login to access The OPEN MINDS Circle Library. Not a member? Create your free account now!

Close

Support Request

Need help now?

Call our toll-free phone number 877-350-6463