Times Are Changing, But Reimbursement & Technology Continue To Top The List – This Year’s Most-Read Circle Briefings

Executive Briefing | by | July 15, 2017

Monica E. Oss
Monica E. Oss

We have six months of 2017 under our belts and the changes remaking the health and human service landscape have shown no signs of slowing. A quick look at our statistics for the first half of the year finds that value-based reimbursement, HIPAA audits and fines, and foster care top the list of briefing topics important to executives. Be sure you didn’t miss these executive briefings from our team:

Athena Mandros

Athena Mandros

Where Are We On The Path To Value-Based Reimbursement?
The theme of The 2017 OPEN MINDS Performance Management Institute was the move to value-based reimbursement. We had lots of great presentations on both health plan and provider organization value-based program innovations. But as a whole, where exactly are we on the path to value-based reimbursement? The move to managed care is continuing across all payer sectors and those payers are now including provider organizations in risk-based arrangements…

Monica Oss, OPEN MINDS

Monica Oss

HIPAA Fines & HIPAA Audits On The Rise
If you were watching, 2016 was a banner year for Health Insurance Portability and Accountability Act (HIPAA) enforcement. The U.S. Department of Health & Human Services’ Office for Civil Rights (OCR) set a department record last year with a total of 12 health care organizations fined and violation payments amounting to over $22.8 million. Seven of those settlements were over $1.5 million – with the $5.5 million settlement with Advocate Health Care Network marked…

Sarah Threnhauser

Sarah Threnhauser

What Might Work To Improve Outcomes Of Youth Aging Out of Foster Care
The “outcomes” for the 24,000 youth in the foster care system that enter adulthood each year don’t look good – they are less likely to graduate college, are more likely to be unemployed or underemployed, and have limited financial resources. The advocacy group Children’s Rights reports that 47% of former foster children are unemployed, and of those with jobs, 71% report an annual income of less than $25,000…

Brian Wheelan

The Value Train Has Left The Station

“We are nothing without our provider partners.” That is a memorable phrase from the keynote address, “Emerging Medicaid Performance Expectations – How They Are Shaping Future Payer/Provider Relationships”, given today by Brian Wheelan, Chief Strategy Officer and Executive Vice President, Beacon Health Options, at The 2017 OPEN MINDS Performance Management Institute. Mr. Wheelan provided a great contextual review of the current value-based reimbursement environment in behavioral health and social services, and then…

Medicaid Behavioral Health Carve-Outs – 11 Remain

The push for integrated care coordination as a cost containment strategy has been widespread. One casualty of this change has been a reversal of the preference for Medicaid behavioral health carve-outs. In 2013, the number of state Medicaid plans with at least one primary carve-out to a care management organization was 17 — six of which were carve-outs to county or governmental agency and 11 of which were carve-outs to private care management organizations (CMO). By the beginning of 2017, that number dropped to just 11 carve-outs to CMOs.

Opioid Addiction – The Crisis, The Impact & The Responses

The opioid situation in the U.S. gets lots of ink in the popular press because its impact is now extended beyond health policy and into the day-to-day lives of Americans. Opioid-related deaths are up — a county-by-county study of deaths in the U.S. revealed a 200% or more increase in deaths related to substance abuse and mental health in 2,000-plus counties across the United States — and that includes the Appalachian regions of Ohio, Kentucky, and West Virginia, where fatalities went up by more than 1,000% between 1980…

The Internet Of Things – The Future & Now

“IoT [Internet of Things] is changing and transforming everything from business to life. Imaginations are boundless and opportunities are infinite.” – Mehul Nayak, Tech.co. “The Internet will disappear. There will be so many IP addresses, so many devices, sensors, things that you are wearing, things that you are interacting with, that you won’t even sense it.” – Eric Schmidt, Google chairman. “Smart homes and other connected products won’t just be aimed at home life. They’ll also have a major impact on business.” – Jared Newman, Fast Company

Paul Neitman

Social Impact Bonds: Small Model, Big Implications For Value-Based Reimbursement

If your organization is going to prepare for the change to value-based reimbursement, what do you do and how do you get there? The answer — determine what health plans want, develop a model that delivers that, and build infrastructure with performance measurement capability. That was the focus of my recent piece featuring Brian Wheelan, chief strategy officer and executive vice president of Beacon Health Options. This got me to thinking: How applicable are those organizational skills to other areas of health and human…

How Much Residential Addiction Treatment Capacity Do We Need?

The opioid epidemic has gotten a lot of attention both within the behavioral health community, but also by the general public. And health policy makers, provider organizations, and local and state governments are working to find and implement solutions. One of the major solutions being adopted includes the expansion of residential treatment benefits for both the Medicaid population, as well as those with other types of health insurance. Last week, we wrote about a demonstration program that allows state Medicaid programs to…

Be sure to check out all of the 2017 executive briefings from the OPEN MINDS market intelligence team at OPEN MINDS Circle Executive Briefings.




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