Managed Care & Value-Based Reimbursement

The impending shift to value-based reimbursement (VBR) and managed care in the health and human services industry has become a driving force across both public and private sector organizations, not only forcing new operating models and systems, but pushing providers to develop new partnerships with payers and to prepare for population health management. This shift presents organizational, technical, and cultural challenges that require a robust technology infrastructure, data-driven decisionmaking, and new leadership competencies. As behavioral health provider organizations move towards risk-based contracts, those who adapt to this change will have a better opportunity to carry forward in the provision of value-based services.

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Orange County, California is preparing to implement value-based contracting (VBC) as part of its Behavioral Health System Transformation (BHST) Innovation effort funded by the Mental Health Services Act (MHSA). The project to develop the infrastructure for VBC began in October 2019 and will run through June 2022. The county’s goal for VBC is to improve quality of and access to culturally responsive and inclusive behavioral health (mental health and addiction) services for all Orange County residents, regardless of insurance type. To help community stakeholders plan strategies for VBC, the Orange County Health Care Agency (HCA) contracted with non . . .
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