For the executive teams of most provider organizations, working with health plans is one of the most strategic and challenging steps to financial sustainability and financial success. Comprehensive managed care organizations (MCOs) enroll 75% of Medicaid beneficiaries, according to recent data (see 10 Things To Know About Medicaid Managed Care).
On the Medicare side, enrollment in Medicare…
To capture growth, achieve sustainability, and build and maintain strategic relevance in today’s health and human services landscape, I am often advising specialty provider organizations to stop simply reacting to market conditions and begin grounding their strategies in data-driven market insights. No matter the goal, the way forward requires informed, intentional decision-making driven by accurate…
In today’s behavioral health landscape—marked by underfunding, fragmented infrastructure, and high-acuity populations—organizational success increasingly depends on the ability to form authentic, mission-aligned payer/provider partnerships. Executives seeking to create value through trust, shared risk, and outcome-driven innovation must learn how to bridge payer/provider divides and address structural care gaps through sustainable business models.
At The 2024 OPEN MINDS Strategy…
Executive teams at specialty provider organizations face a pressing, overarching question: how can they build stronger, more strategic relationships with health plans? The answer to that question is critical for sustaining revenue, securing better rates and referrals, and positioning their organizations for long-term relevance in a system moving rapidly toward value-based care.
Finding the right…
