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

• Advancing CCBHC System Competencies​ With Prospective Payment & Value-Based Reimbursement Contracting​; A Capabilities Statement Prepared For State Assistance
• Inside The Payer View: The Future of Addiction Treatment Service Delivery– Sponsored By Recademy
• The Risk Plunge
• Long-term Enhanced ACO Design (LEAD) Model
• What Is The ‘Value’ Of Health Care?
• VBR Sputter or Surge?
• Who Moved The Medicaid Cheese? A Look At Some Of The Largest 2025 Contract Awards
• Understanding Medicaid Managed Care Procurement Practices Across States
• Medicaid Managed Care Procurements: A Toolkit For State Medicaid Agencies
• Medicaid Managed Care Plan Transitions: A Toolkit For States On Promoting Continuity Of Care When Plans Enter, Leave, Or Merge Or Are Acquired
• The Changing Face of Medicaid Managed Care: The Most Downloaded OPEN MINDS RFPs Of 2025
• Rewriting The County Playbook
• The State Of It All
• The Tech Of Aging
• The State I/DD Challenge

Amerigroup DC Launches Medicaid Value-Based Agreement With DC Connected Care Network

Amerigroup District of Columbia (DC), Inc. and the DC Connected Care Network (DC CCN), a clinically integrated network for federally qualified health centers (FQHCs), announced on April 10, 2025, that they launched the District of Columbia’s first Medicaid value-based agreement (VBA). This three-year agreement includes the DC Primary Care Association (DCPCA) and seven of its FQHC members: Bread for the City, Community of Hope, Family Medical Counseling Services, La Clinica del Pueblo, Mary’s Center, Unity… Read

• Child First & Center
• Data-Driven Whole Person Care
• VBR Momentum
• Blue Cross & Blue Shield Of North Carolina – Winning Proposal & Contract For Medicaid Children & Families Specialty Plan Services To North Carolina Department Of Health & Human Services, 2024
• 64% Of Health Care Organizations Expect Increased Value-Based Care Adoption

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