For decades, the movement toward value-based reimbursement (VBR) models in the United States has been “glacial”—slow but sure, changing everything in its path. But the pandemic has accelerated the movement to value. And, the movement has been fueled by recent developments—tightened government budgets in a recovering economy, a focus on “whole person” approaches to care management, the entry of…
Today, 61% of all health care payments in the United States are tied to performance. Of this, 25% of payments are fee-for-service with a link to quality and value. And 36% of payments are alternative payment models (APMs)—with shared savings, shared risk, bundled payment, population-based payments, integrated finance and delivery system payments. By comparison, APMs…
SPARC Services & Programs (SPARC) is a behavioral health provider organization in North Carolina that has been providing home and community-based services since 2015. They serve 425 consumers monthly and employ 70 full-time staff. They focus on complex consumers—children and adults with severe and persistent mental illnesses (SPMI) who have not been successful with residential…
Eleanor Health is a startup specialty provider organization offering medication assisted treatment, psychiatry, therapy and counseling, recovery coaching, and care management and coordination for physical health issues and to address social determinants of health. Services are provided onsite and in-person, virtually, or at home and in the community in Louisiana, Massachusetts, North Carolina, New Jersey,…
Founded in 1949, Hazelden Betty Ford Foundation today provides inpatient and outpatient addiction treatment, co-occurring mental health care, recovery resources and related prevention and education services to individual adults and youth, families and communities affected by addiction to alcohol and other drugs. It employs 1,500 staff and serves more than 25,000 people annually. Headquartered in Center…
All health care organizations should be planning for Value-Based Reimbursement (VBR) and other alternative payment models. Conducting a gap analysis is a first step to planning this paradigm change, which can otherwise be overwhelming.
The OPEN MINDS Value-Based Reimbursement Readiness Assessment focuses on six organizational and technical domains that are critical to making a successful transition:
