Managed Care & Value-Based Reimbursement

The impending shift to value-based reimbursement (VBR) and managed care in the health and human services industry has become a driving force across both public and private sector organizations, not only forcing new operating models and systems, but pushing providers to develop new partnerships with payers and to prepare for population health management. This shift presents organizational, technical, and cultural challenges that require a robust technology infrastructure, data-driven decisionmaking, and new leadership competencies. As behavioral health provider organizations move towards risk-based contracts, those who adapt to this change will have a better opportunity to carry forward in the provision of value-based services.

Latest Resources

• Texas Seeks STAR Kids Managed Care Services
• The Hartford – Winning Contract For Short-Term & Long-Term Disability Program Services To Delaware State Employee Benefits Committee, 2024
• Highmark Delaware – Winning Contract For Employer-Sponsored Medicare Supplement Plan Services To Delaware State Employee Benefits Committee, 2024
• Wisconsin Community Services, Inc. – Winning Proposal & Contract For Children’s Long-Term Support Waiver Program Support & Service Coordination To Wisconsin’s Milwaukee County Department Of Health & Human Services, 2024
• Lutheran Social Services Of Wisconsin & Upper Michigan, Inc. – Winning Proposal & Contract For Children’s Long-Term Support Waiver Program Support & Service Coordination To Wisconsin’s Milwaukee County Department Of Health & Human Services, 2024
• Life Navigators – Winning Proposal & Contract For Children’s Long-Term Support Waiver Program Support & Service Coordination To Wisconsin’s Milwaukee County Department Of Health & Human Services, 2024
• Orange County Health Authority DBA CalOptima Health – Winning Contract Documents For Be Well OC Wellness Hub Services To Orange County Health Care Agency, 2024
• Telecare Corporation – Winning Proposal & Contract For Medi-Cal Mobile Crisis Service Benefit Implementation Services To California’s San Mateo County Health System, 2024
• Michigan Awards $15 Billion Medicaid Managed Care Contracts To Nine Health Plans
• Value-Based Care Might Serve As Trigger For Expanded Care Integration
• The Medicaid RFP Cycle
• Consistent Care Coordination Improves Outcomes For Medicare Advantage Members
• Panoramic Health & The Kidney & Hypertension Center Partner To Provide Kidney Care Services In Ohio 
• HealthPartners – Winning Contract For Medicaid Prepaid Health Care Services To Eligible Individuals Through The Special Needs BasicCare & Integrated Special Needs BasicCare To Minnesota Department Of Human Services, 2024
• Conduent State Healthcare, LLC – Winning Proposal For Division Of Family Resources Learning & Development Services To Indiana Family & Social Services Administration, 2024

Pennsylvania Medicaid Rebids Community HealthChoices LTSS MCO Contracts

Indiana Family and Social Services Administration awarded a $18,850,682 contract to Conduent State Healthcare, LLC to provide learning and development services for the Division of Family Resources (DFR) eligibility operations. The Eligibility Operation is the central resource in helping Hoosiers apply and receive benefits, including but not limited to SNAP, TANF, IMPACT, Medicaid, HIP 2.0, Hoosier Healthwise, Medicaid Burial Program, Refugee Benefits, and Hoosier Care Connect. Briljent, LLC and Deloitte Consulting, LLP also responded to… Read

• Hennepin Health – Winning Contract For Medicaid Prepaid Health Care Services To Eligible Individuals Through The Special Needs BasicCare & Integrated Special Needs BasicCare To Minnesota Department Of Human Services, 2024
• HealthPartners – Winning Contract For Medicare Prepaid Health Care Services To Eligible Individuals Through The Senior Health Options & Senior Care Plus To Minnesota Department Of Human Services, 2024
• Blue Plus – Winning Contract For Medicare Prepaid Health Care Services To Eligible Individuals Through The Senior Health Options & Senior Care Plus To Minnesota Department of Human Services, 2024
• UnitedHealthcare Of Illinois, Inc. – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024
• UCare Minnesota – Winning Contract For Medicaid Prepaid Health Care Services To Minnesota Department Of Human Services, 2024