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The Field Guide to Managed Care: A Primer

Developing a Model Concept and Clientele, with Potential Partners and Services

By Erin Lockwood and Lori Peterson

A step-by-step primer for organizations wanting to prepare a service model and form a partnership with a healthcare entity.

S uccessful partnerships often exhibit a number of common attributes, including strong communication, trust, and value for all parties, but less recognized is the structure that allows for these successes—the model design. The key to designing a model is first to create a framework that lays out every aspect of the relationship, from oversight to day-to-day operations. This article explores areas to con- sider as an organization develops a model and secures partnerships to improve the health system in their community. Though positioning for a partnership with the healthcare sector may require a shift in approach and mindset, it is important to realize an organization’s extant potential. Assets and skills already present can be used and improved to make the organization more sustain- able. Repositioning or repackaging the organization’s services can lead to suc- cess, as can peer education. For example, the In- stitute on Aging in San Francisco repurposed and repackaged a nursing home diversion pro-

gram they had run for years, and secured a multi- million-dollar, value-based contract with a healthcare payer. It is now replicating this model for additional payers. Preparing to Design the Model Though it may be tempting to jump straight to a model, it is crucial to strategically prepare for engaging healthcare providers and payers, as there are a number of avenues a partnership might follow. It is highly recommended that the organization complete an internal and external assessment first, plus develop a value proposi- tion. The key to securing new partnerships is for One community organization secured a multi- million-dollar contract with a healthcare payer by repurposing and repackaging their longtime nursing home diversion program.

an organization to convince the partner that their services hold value, and that it is the best entity to deliver that value.

abstract Successful partnerships often exhibit a number of common attributes, including strong communication, trust, and value for all parties, but less recognized is the structure that allows for these successes—the model design. The key to designing a model is first to create a framework that lays out every aspect of the relationship, from oversight to day-to-day operations. This article explores areas to consider as an organization develops a model and secures partnerships to improve the health system in their community. | key words : healthcare partnership, internal and external assessments, value proposition, managed care model

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