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.

Latest Resources

• Value-Based Care Might Serve As Trigger For Expanded Care Integration
• The Medicaid RFP Cycle
• Consistent Care Coordination Improves Outcomes For Medicare Advantage Members
• Panoramic Health & The Kidney & Hypertension Center Partner To Provide Kidney Care Services In Ohio 
• 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

Pennsylvania Medicaid Rebids Community HealthChoices LTSS MCO Contracts

Minnesota Department of Human Services awarded nine contracts to provide prepaid health care services to eligible individuals through the Families and Children Medical Assistance and MinnesotaCare. There were no additional responses reported to this solicitation. Read

• 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
• Steward Health Care Network – Winning Proposal For Medicaid Accountable Care Organization Services To Massachusetts Executive Office Of Health & Human Services, 2024