Value-Based Contracting
The OPEN MINDS 2024 Innovation Survey reveals that the biggest increase in value-based contracting was in care coordination models. By 2025, over 60% of healthcare payments will be tied to performance-based incentives, with behavioral health playing a key role. Every behavioral health provider needs the know-how to participate in value-based arrangements. Our value-based contracting resources offer the opportunity to optimize participation and performance in value-based arrangements including knowledge and information exchange about best practices for successful collaborations, contract negotiations, reimbursement valuations, member engagement, metric management, and more.
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Improving Behavioral Health Systems Through Operational Integration: Efforts In San Mateo County
By California Health Care Foundation California’s Medi-Cal delivery system is fragmented. In Medi-Cal, managed care plans are responsible for physical health care and some mental health services, while plans run […]
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Measuring Performance—Data Integration Matters
By Monica E. Oss, Chief Executive Officer, OPEN MINDS Most provider organization executive teams don’t have an option for what performance metrics they report to their payers—whether states, counties, employers, […]
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Louisiana Awards Medicaid Managed Care Contracts With Enhanced Focus On Behavioral Health Integration
By OPEN MINDS Circle On February 11, 2022, the Louisiana Department of Health (DOH) announced its intent to award Medicaid managed care organization (MCO) contracts to five MCOs: CVS/Aetna Better […]
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CMS Approves CalAIM Medicaid Waiver
By OPEN MINDS Circle On December 29, 2021, the Centers for Medicare & Medicaid Services (CMS) approved the California Advancing and Innovating Medi-Cal (CalAIM) Medicaid waiver amendment and renewal for […]
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The “Ideal” Health Home?
By Monica E. Oss, Chief Executive Officer, OPEN MINDS As we look ahead to 2022–with more integration and more value-based care, the question is how do specialty provider organizations “fit” […]
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Tennessee Announces Intent To Award Next Medicaid MCO Contracts To Incumbents; Contracts Include Changes In Coverage Options For Consumers With I/DD
By OPEN MINDS Circle On November 8, 2021, the Tennessee Division of TennCare announced intent to award Medicaid managed care organization (MCO) contracts to incumbents Anthem/Amerigroup Tennessee, Blue Cross Blue […]
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Anthem Selects Somatus To Deliver Personalized, Value-Based Kidney Care
By OPEN MINDS Circle On November 3, 2021, Somatus, which provides a value-based kidney care management model, announced it entered a long-term, multi-year partnership with Anthem, Inc. Somatus began providing […]
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NCQA Accredits Somatus’ Kidney Care Management For Population Health & Case Management
Somatus, which provides value-based kidney care, was awarded the National Committee for Quality Assurance’s (NCQA) Population Health Program (PHP) and Case Management (CM) Accreditations. Somatus is the only value-based kidney […]
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If You Can’t Keep Score, You Can’t Be In The Game
By Monica E. Oss, Chief Executive Officer, OPEN MINDS When it comes to numbers, the offense is tough. Consumers are selecting provider organizations based on performance ratings. Consumers in treatment also […]
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Nevada Awards Medicaid Managed Care Contracts To Anthem, Centene, Molina & UHC
By OPEN MINDS Circle On August 5, 2021, the state of Nevada awarded Medicaid managed care organization (MCO) contracts to Anthem (Community Care Health Plan of Nevada, Inc.), Centene (SilverSummit […]