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.
Editor’s Picks
- Rhode Island Rebids Medicaid Managed Care Services
- Molina Misses Readiness Review Deadline For Indiana Medicaid Managed Long-Term Care Contract
- Medicaid MCO Prior Authorization Denial Rates Double Medicare Advantage Denials; MACPAC Recommends Changes To State & Federal Oversight
- Wisconsin Medicaid Rebids Family Care LTSS Programs For Consolidating South-Central Region
Latest Resources
- HealthPartners – Winning Contract For Medicaid Prepaid Health Care Services To Eligible Individuals Through The Special Needs BasicCare & Integrated Special Needs BasicCare To Minnesota Department Of Human Services, 2024
- Conduent State Healthcare, LLC – Winning Proposal For Division Of Family Resources Learning & Development Services To Indiana Family & Social Services Administration, 2024
- Hennepin Health – Winning Contract For Medicaid Prepaid Health Care Services To Eligible Individuals Through The Special Needs BasicCare & Integrated Special Needs BasicCare To Minnesota Department Of Human Services, 2024
- HealthPartners – Winning Contract For Medicare Prepaid Health Care Services To Eligible Individuals Through The Senior Health Options & Senior Care Plus To Minnesota Department Of Human Services, 2024
- Blue Plus – Winning Contract For Medicare Prepaid Health Care Services To Eligible Individuals Through The Senior Health Options & Senior Care Plus To Minnesota Department of Human Services, 2024
- UnitedHealthcare Of Illinois, Inc. – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- UCare Minnesota – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- South Country Health Alliance – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- PrimeWest Health – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- Medica Health Plans – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- Itasca Medical Care – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- Public Partnerships, LLC – Winning Contract For Housing Payment Services For Traumatic Brain Injury & Nursing Home Transition & Diversion Waiver Housing Subsidy Participants To New York Department Of Health, 2024
- HealthPartners, Inc. – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- Hennepin Health – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- Health New England, Inc. – Winning Proposal For Medicaid Accountable Care Organization Services To Massachusetts Executive Office Of Health & Human Services, 2024
Massachusetts Executive Office of Health and Human Services awarded seven contracts to serve as Accountable Care Partnership Plans and Primary Care Accountable Care Organizations under its Accountable Care Organization program. Read
- Steward Health Care Network – Winning Proposal For Medicaid Accountable Care Organization Services To Massachusetts Executive Office Of Health & Human Services, 2024
- Choice Of Dental Care Delivery Program – Winning Contract For Medicaid Dental Services To Utah Department Of Health & Human Services, 2024
- Blue Plus – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
- MCNA Insurance Company, Inc. – Winning Proposal For Dental Medicaid Managed Care Services To Arkansas Department Of Human Services, 2024
- Delta Dental Plan of Arkansas, Inc. – Winning Proposal For Dental Medicaid Managed Care Services To Arkansas Department Of Human Services, 2024
Latest Industry Bulletins
- Florida Medicaid Awards I/DD Managed Care Pilot Contract To Florida Community Care
- WellBe Senior Medical Secures Investment From CVS Health Ventures To Accelerate Nationwide Expansion
- Equality Health Joins Accountable For Health To Speed Transition To Accountable Care
- Alera Health & Affiliated Network Providers Enters Value-Based Agreement With Mercy Care In Phoenix, Arizona
Latest Industry News
- Iowa Seeks Medicaid MCO To Replace Expiring Contract With Total Care
- Washington Medicaid Integrated Medical & Behavioral MCOs Fail to Outperform Carve-Outs in Behavioral Health Access In First 2 Years
- Increases In Value-Based Payment Adoption Decreased Burnout Among Primary Care Physicians
- Michigan Rebids Medicaid Managed Care Contracts For 2024 To Implement MIHealthyLife Initiative
- Washington State Purchasers Align To Support State’s Participation In CMS Making Care Primary Model