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 straight from the field—the results of our just-completed national survey of value-based reimbursement (VBR) among specialty provider organizations. In a nutshell, the survey results revealed that VBR is gaining momentum, slowly but surely. About one third of specialty provider organizations reported participating in VBR arrangements with payers, and about 71% report having contracts with ACOs and managed care plans. Not unexpectedly, large organizations are more likely than smaller ones to be participating in VBR arrangements. VBR is more common in FQHC/primary care organizations and not very common in the I/DD sector.
We found that the most common measures in VBR contracts remained the same year to year. Follow-up after hospitalization, emergency room use, and readmission rates topped the list. For most provider organization executives, these constitute the “must have” organizational performance measures if you’re interested in building partnerships with health plans.
So what do executives of specialty provider organizations think they need to be successful in this changing environment? Their answers were consistent with our findings over the last few years. In priority order, executives said they need:
- More and better data management and reporting for managing VBR contracts
- A technology infrastructure that supports VBR
- Management talent with the expertise to use that data to manage care
I think these needs are very different. I view the first and second as technical issues—with enough capital and some time, any organization can put them in place. But the third—the management talent—is not only an issue of hiring the talent. To become a successful data-driven organization requires a change in culture—a willingness to change processes and people to optimize performance. This is the primary reason why so many provider organizations are challenged (and often fail) in moving away from fee-for-service to VBR.
For more on best practices in the move to pay for value, check out our coverage of The 2018 OPEN MINDS Performance Management Institute through our live social media coverage @openmindscircle under the official hashtag #OMPerformance. And check out these resources in the OPEN MINDS Circle library:
- Building A Technology Infrastructure For Value-Based Care: Tech To Support Performance Management
- Tech Step #1: Getting The Data You Need
- The Essential Tech List For Value-Based Purchasing
- Tech Step #2: Using Data To Optimize Consumer Care Coordination & Population Health Management
- Structuring (& Budgeting For) Analytics
- What Are Health Homes Measuring?
- Does Paying For Value ‘Work’?
- Can Data Fix It?
- How Do We Automate Population Health Management?
To see how your organization stacks up, check out The 2018 OPEN MINDS Performance Management Executive Survey: Where Are We On The Road To Value?. The full survey is available to all OPEN MINDS Circle readers with the generous support of Netsmart, and contains information on:
- The percent of specialty provider organizations with contracts with non-governmental health plans and accountable care organizations
- The percent of specialty provider organizations with service revenue in value-based reimbursement
- The types of value-based reimbursement models adopted by provider organizations
- The percent of specialty provider organization revenue in value-based reimbursement
- The top challenges to adopting value-based reimbursement
- The percent of organizations that have adopted performance-based compensation for staff
For even more, join us on June 6 at The 2018 OPEN MINDS Strategy & Innovation Institute for the plenary address, “Going Beyond Innovation—Developing Partnerships With Health Plans,” by Charles Gross, Ph.D., Vice President, Behavioral Health, Anthem, Inc.