Healthcare in the United States is quickly moving from a fee-for-service to pay-for-performance model. While larger healthcare systems and physical health providers are already held accountable for the care they provide to individuals through CMS’ reimbursement changes, community-based behavioral health providers also can expect to have their payers and funding streams move toward a performance-based contracting and funding approach in the near future.
This training will describe how Magellan Healthcare, Inc., a leader in managing the fastest-growing, most complex areas of healthcare, has approached value-based purchasing with community behavioral health providers. Magellan’s approach couples performance improvement and provider engagement with health analytics, which include cost and quality outcomes, to successfully support providers in achieving higher performance and payment for performance that bridges the gap between cost and quality.
· Identify key components of value-based collaboration and purchasing (from Magellan Healthcare’s perspective) and how each of the components must be considered when moving to value-based contracting.
· Interpret value-based collaboration and purchasing from a payer’s perspective and understand how the provider feedback and participation has and does play a role in the development of value-based purchasing at Magellan Healthcare.
· Recognize the direction in which value-based purchasing is moving in behavioral healthcare, specifically in community-based care.
Members: $25 | Nonmembers: $50
Monica Collins joined Magellan Healthcare in 2013 as the director of provider engagement for behavioral health. Her experience includes more than 20 years of work in behavioral health providing direct clinical care, and serving as the director of clinical operations for several years at a community mental health center in New Hampshire. In 2012, Monica moved into the payor side of healthcare and joined a Medicaid health plan as the clinical director of behavioral health.
Monica has a master’s degree in counseling, an MBA and a Certificate in Integrated Care.