Defining Your Value: How to Develop and Use Your Value Proposition - - PowerPoint PPT Presentation
Defining Your Value: How to Develop and Use Your Value Proposition Wednesday, May 15 th 12-1pm National Council for Behavioral Health Montefiore Medical Center Northwell Health New York State Office of Mental Health Netsmart Technologies
Wednesday, May 15th 12-1pm
National Council for Behavioral Health Montefiore Medical Center Northwell Health New York State Office of Mental Health Netsmart Technologies
Maura Gaswirth, LICSW Director, Training and Technical Assistance, National Council for Behavioral Health Mindy Klowden, MNM Director, Training and Technical Assistance, National Council for Behavioral Health
Step 1: Understand What is Meant by “Value Proposition” Step 2: Conduct a Stakeholder Analysis to Understand Who Your Value Proposition is For Step 3: Identify and Collect What Data You Will Need to Build Your Value Proposition Step 4: Craft Your Actual Value Proposition Step 5: Develop Your Communications Strategy for Your Value Proposition Step 6: Enhance Your Value Proposition Through Partnerships as Needed Step 7: Update and Tailor Your Value Proposition
✓Explains what benefit your organization provides, for whom, and how you do it uniquely well. ✓Builds the case that you are better positioned to meet the community’s need than your competitors. ✓A living document that can be updated as needed and is tailored to different audiences.
✓Accountable Care Organizations ✓Independent Provider Associations ✓Other current or potential partners ✓Policy makers ✓State and County Administrators ✓Managed Care Organizations ✓Commercial payers ✓Potential clients
✓The “Center for Behavioral Health” sees 10,000 clients annually, and 85% have Medicaid. ✓The State contracts with Managed Care Organizations and provides much flexibility. ✓XYZ Health Group is the largest Medicaid Managed Care Organization in the region. Conclusion: XYZ Health Group is the most important partner to influence if CBH wants to pursue a value-based contract.
✓Like all MCOs, XYZ Health Group is interested in market share. ✓XYZ Health Group is committed to reducing the total cost of care through appropriate utilization patterns. ✓XYZ Health Group has been piloting value-based payment models including pay-for-performance, bundled payments and shared savings. ✓They like predictability and appreciate when providers know the utilization patters, morbidity rates and demographics of their clients. How does CBH know all of this? Intelligence gathered from the MCO procurement process, literature review, stakeholder meetings, and previous contracting meetings.
What community need do you address?
with behavioral health disorders lack access to appropriate services. Some are using the hospital as their primary source of care, and their post- discharge care is not being well coordinated.
Whom do you serve?
serious mental illness and/or substance use
have co-morbid chronic health conditions. 79%
coverage through XYZ Health Group.
How do you meet the community’s needs?
provide an array of psychiatric and counseling services using validated screening tools and evidence based
new follow up care program targeting clients with serious mental illness who have been hospitalized for psychiatric reasons.
Why are you better than your competitors?
data analytics
data that show we can get clients seen within 7 days post- hospitalization at a higher rate than the MCO average. We are efficient and keep
79% 11% 5% 5%
XYZ Health Group Other MCO Medicare Uninsured
45% 50% 50% 70%
0% 10% 20% 30% 40% 50% 60% 70% 80%
MCO Average NCQA Benchmark CBH Rate Prior to Program CBH Rate Year 1
Service Hourly Cost Average Utilization Total Care Coordination (Masters level) $150 2 $300 Prescriber (MD or NP) $330 1 $330 Outpatient therapy (Masters level) $150 1 $150 Community support (Peer or Bachelors) $55 2 $110 Sub-total $890 Administrative costs (includes occupancy) 18% $160 Total $1,050
The Center for Behavioral Health (CBH) has provided evidence-based mental health since 1978. Eighty four percent of CBH clients have Medicaid managed care through the XYZ Health Group. We provide a continuum of recovery-oriented services that help ensure adults experiencing a serious mental illness or substance use disorder, can lead healthier, productive lives. All too often, adults with (SMI) lack adequate community-based treatment and use the hospital as their primary source of care, and their post-discharge care is not being well coordinated. At CBH licensed clinicians provide an array of services including: psychiatric care and medication management; individual, family and group counseling services; nurse care management and care coordination services; wellness services focused on whole-person care; and peer support. CBH also specializes in post-acute care and has successfully piloted a 7 day follow program to ensure appropriate coordination of care for adults with SMI who have been hospitalized for psychiatric reasons. We are unique because of our strong organizational philosophy of being patient-focused, outcomes
impact of our services is clear. Last year: ➢ Seventy percent of clients referred to CBH following psychiatric hospitalization were seen within one week, compared to the MCO average of 45%. ➢ Eighty percent of CBH clients reported they were satisfied or highly satisfied with our services. ➢ Eighty two percent of revenues went directly to patient care. “Kelly” is one of many clients whose lives have been changed by CBH. According to Kelly, “About a year ago I was having severe mood swings and gaining a significant amount of weight. I did not want to get
like I did not have anywhere else to turn. Fortunately, CBH’s Care Coordinator met with me upon my last hospital discharge and helped me connect with their services. I started meeting with a Psychiatrist as well as a social worker. I have not been back to the hospital in almost a year now. I feel like CBH turned my life around. For the first time in a long time, I have hope for a better future.” With your support, CBH can reach more clients like Kelly and help reduce unnecessary readmissions.
Know
your costs.
Remember
building a personal relationship.
Prepare
to share your value proposition and all relevant data.
Bring
the right people to the room.
Look
for the win-win.
Understand
what is important to the payer per your stakeholder analysis.
Know
when your contracts can be renewed or renegotiated.
different than an improvement story. It defines what your value is, rather than how you got there.
population being managed.
population management approach.
guidelines to describe performance, but also consider and include information on next steps to fully capture value.
development and drafting with National Council communications experts
developing your exemplary practice story
Review the template with your team and start writing Review your data
Submit your story by June 15th for review and submission
Event Date and Time What Non-Prescribers Need to Know About Simultaneous Use of Multiple Antipsychotics Tuesday, May 21 from 12:00-1:00pm Health Information Technology and Behavioral Health Performance Metrics Wednesday, May 28 from 1:00-2:00pm Practitioner Interventions: Assessing, Documenting and Addressing Medication Non-Adherence Thursday, May 29 from 12:00-1:00pm Organizational Practices and Policies to Support Medication Adherence Tuesday, June 11 from 12:00-1:00pm
Contact: Mindy Klowden, MNM Director, Training and Technical Assistance Mindyk@TheNationalCouncil.org Maura Gaswirth, LICSW Director, Training and Technical Assistance MauraG@TheNationalCouncil.org
The project described was supported by Funding Opportunity Number CMS-1L1-15-003 from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services. Disclaimer: The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.