The last few months have brought some significant change to the health and human service landscape. But one constant is that the move toward ‘whole person’ care models and integrated delivery systems continues (though the corresponding move to value-based payment models for provider organizations needed to support it is lagging a bit). Several major Medicaid RFPs focus on integrated service delivery systems—and the market is likely to follow. The challenge for executives of specialty provider organizations is the right market positioning (and capabilities) for an integrated market landscape.
A recent article, Looking Toward The Future Of Integrated Care: History, Developments, And Opportunities, outlined the challenges facing the behavioral health market sector in an increasingly integrated landscape. Most fundamental is for behavioral health provider organizations to move to population health management model of service with integrated community interventions. But to do this, payers and health plans need to change provider reimbursement with more thought to bundled and capitated rates that support consumer-centric service models. While increasing fee-for-service rates—and payment for—the services that are part of whole person care models and the workers delivering those services, these models will expand to scale faster with a change in reimbursement model.
Along the same lines, the authors also recommend that executives teams rethink their workforce, and the technology required to support service delivery. This will require not only expanding the definition of the service delivery workforce, but also moving their scope of practice and training from a purely clinical approach to one that also includes community-level interventions. This shift can (and should) be supported by technology—to speed documentation, diagnosis, clinical decision support, and outcomes measurement.
