Author: Sarah Kinsler*
June 2018 | Brief
Payment and delivery system reforms are critical to achieve the Triple Aim of improved health, improved patient experience and quality, and reduced cost. As participation in alternative payment methodologies grows, payers and providers are increasingly realizing that partnerships with community-based behavioral health and long-term care providers are essential to achieving Triple Aim goals, including realizing savings from payment reform efforts. Readiness to participate in payment reform, however, is often a challenge for community-based behavioral health and long-term services and supports (LTSS) providers.
This brief examines the competencies necessary for community-based behavioral health and long-term care providers to successfully participate in alternative payment models, discusses the barriers these providers face, and explores how states, the federal government, and private organizations can increase providers’ readiness to participate in payment reform activities.
Two companion case studies highlight examples where public and private organizations successfully partnered to increase community-based behavioral health and LTSS provider readiness for payment reform.
Vermont Care Network and the State of Vermont: A Shared Data Repository for Community-Based Behavioral Health Providers – The State of Vermont, federal Health Resources and Services Administration, and Vermont Care Network, a statewide provider network, partnered to build a data repository for Vermont’s Designated Mental Health Agencies and Specialized Service Agencies, which serve Vermonters with mental health, substance use disorder, and developmental disabilities. This case study describes key factors considered in developing the Vermont Care Network data repository.
Administration for Community Living: Improving Business Acumen for Community-Based Aging and Disability Organizations through Learning Collaboratives – The federal Administration for Community Living (ACL) convened a series of Learning Collaboratives to improve contracting skills and other business competencies among networks of community-based aging and disability organizations, as part of a larger Business Acumen Initiative. This case study describes the ACL Business Acumen Learning Collaborative, and reviews key takeaways and next steps for supporting business capacity building for these critical organizations across the country.