Hillsides Cares Case Study: Service Expansion, Health Plan Contracting & Strategic Repositioning for California’s Evolving Value-Based Market
The health and human services field is evolving, and nowhere more than in California with the implementation of CalAIM and systemwide transformation to value. Specialty providers, health plans, and payers need to address these changes together through aligned payer-provider goals. OPEN MINDS will be presenting this special quarterly series—March 17, May 26, August 18, and December 1—featuring California Case Studies focused on strategy, health plan contracting, financial assessment, market services and CalAIM Preparedness including readiness, implementation, and technology.
In this session, Garret Zabel and Lucy Garcia, of Hillsides Cares of South Pasadena, California, will discuss their strategy and journey as a non-profit children’s services provider in Los Angeles County to enter the health plan/managed care market. They will share insights into the development of new health plan partnerships that leverage existing county contracted service lines as part of the organization’s sustainability and growth planning in a swiftly evolving managed care and value-based California payer market. The presentation will cover their Hope Initiative – Aetna Managed Care Plan, the Network of Care – ACES Aware Initiative, and their Community Impact Alliance.
Executive attendees will learn:
- Leadership forecasting and organizational assessment to prepare to deliver services to new payers under managed care contracts
- Growth strategy development for payer mix diversification and revenue to compliment traditional government funding from Medi-Cal
- Organizational strategy for health plan market entry, including branding, marketing, website, and referral development for the new service line development of RTC, PHP, ICP, WRAP, and coordinated outpatient mental health.
Featured Speakers
-
Garret Zabel, Director of Business Development, Hillsides CaresMr. Zabel is responsible for developing opportunities that benefit the organization’s mission, market positioning, and financial sustainability. He has oversight of public grant solicitations, commercial payer marketing and contracting, strategic partnerships, service line development, targeted referral outreach, policy reform measures, and multi-sector health initiatives. Prior to joining Hillsides, Garret worked for a social enterprise in rural Northwest Vietnam and The University of Sydney Business School. -
Lucy Garcia, Business Development Analyst, Hillside CaresLucy Garcia oversees the health plan contracting and relationship management process for multiple service lines, including residential and intensive outpatient programs. She supports the business office with responsibilities related to referral development, patient experience, and marketing for commercial programs. Additionally, Ms. Garcia leads market research efforts to identify new service lines for strategic positioning and growth at Hillsides. She is experienced in working with the nonprofit, public, and private sector in the healthcare field. -
Richard Louis, III, Vice President, OPEN MINDSAs OPEN MINDS Vice President – Western Region, Richard Louis, III, brings extensive experience as a behavioral health care administrator, business development specialist, and innovator of new service lines for behavioral health care organizations. His expertise in population health management program development, strategic planning, and payer mix diversification help create programs that target high cost and complex behavioral health populations.
[elite-event]