Fundamentals of Community-Based Managed Care: A Field Guide
Table 1. Core Competencies
place, the CBOs entered into more than twenty contracts with new payers to support care coor- dination and care transitions. They are serving thousands of older adults and generating mil- lions of dollars in new revenue for their organi- zations—all while illustrating a value or return on investment for payers. Beyond the work funded by The SCAN Foun- dation, the Marin Community Foundation and the Colorado Health Foundation have funded efforts similar to the Academy. The Aging and Disability Business Institute (Institute) has taken the Academy to a national level by serving as the go-to source to build the business acumen of CBOs, through acquiring and strengthen- ing skills and knowledge across business disci- plines, while looking ahead to the future of aging and disability services. The Institute was cre- ated in partnership with the Administration for Community Living, with funding from The John A. Hartford Foundation, The SCAN Founda- tion, the Colorado Health Foundation, the Marin Community Foundation, and the Gary and Mary West Foundation. How to Build Business Practices This section of 2018 Spring Generations , “Funda- mentals of Community-Based Managed Care: A Field Guide,” expands on the core competencies by providing practical information and strate- gies. The articles include the following: “Making the Business Case for CBO Ser- vices”: CBOs are well-positioned to exploit the fnancial opportunities created by healthcare reform by providing their services in partner- ships with the healthcare sector. This article explains the method, steps, and key success fac- tors for CBOs to create and make a business case to potential healthcare partners. “A Matter of Mindset”: Home- and commu- nity-based services providers are well-positioned to partner with the medical sector, but this requires an outside-in business mindset. This article outlines the characteristics of such a mindset through a hypothetical case study.
Understand the Market and Competitors Identify Potential Clients Understand Cost of Care Delivery and Develop Rate Structure/ROI
sector partner—also known as adopting an “outside-in” perspective. Organizations that have begun working in this space and those that are just testing the waters need to have strong leadership (including at the board level), the abil- ity to develop new systems and process, and an openness to understanding the healthcare enti- ty’s needs and how their expertise and experi- ence can address those needs. As payment mechanisms continue to move toward rewarding outcomes and encouraging integration, CBOs have a critical role to play in addressing the long-term support services needs. CBOs must hone their business skills to achieve the transformation necessary to successfully secure and deliver outcomes with new payers. The Linkage Lab Academy As a result of this shift in the environment, The SCAN Foundation created the Linkage Lab Academy (Academy). Twelve CBOs in California attended the Academy from 2012 to 2015; the Academy offered these organizations intensive training and education in business development and practices, as well as direct support, through technical assistance, to transform their opera- tions. The Academy’s overarching goal was for CBOs to establish new payer relationships with the healthcare sector. With core competencies (see Table 1, on this page) and infrastructure in Design Model/Service Business Development Marketing and Branding Identify Need for Collaborative Partners and Develop Approach Develop Infrastructure to Operationalize Service Delivery Model People Development Develop Contract and Contingency Plan
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