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July 29
2023 Navigating The Commercial Health Plan Market
2021 Building New Bridges – Behavioral Health & Law Enforcement
2020 Why Unemployment Matters To Health Care Organizations
2019 The Challenge Of Making Best Practice Adoption Happen – The Payer P...
2018 North Carolina Releases Updated Plans For Integrated Medicaid Manag...
2016 The Era Of Value-Based Reimbursement – When Doing More Is Not Enough
2015 Big Shifts Ahead In The California IDD Landscape
2014 Serving Veterans Who May Be Eligible But Unenrolled In The VA Healt...
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Permalink Reply by Paul Terlemezian on
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2014 Serving Veterans Who May Be Eligible But Unenrolled In The VA Healt...
As we continue the exploration of the potential of increasing employee performance and retention by offering alumni and retiree professional development services (by learning about the VA) - let's ask ourselves - how we might prove the ROI of such a program?
Here are some factors to consider:
- Having a "ready" pool of contract and part-time workers
- Access to expertise that would otherwise be unavailable to assure successful succession plans
- Nurturing a source of potential clients, partners or referrals for our company
- PR
- Extension of services to non-alumni (for a fee and profit)
What else comes to mind?
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2015 Big Shifts Ahead In The California IDD Landscape
"....some of the basic policies and practices for serving people with intellectual and developmental disabilities (IDD) are evolving as well..."
Self-Determination (More offerings for people whose medium and long term goals are different from their near-term prioriities)
De-Population of The Developmental Centers (for L&D - perhaps fewer new-hires with college degrees)
Community Crisis Homes & Behavioral Support Centers (More social and cultural experiences)
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2016 The Era Of Value-Based Reimbursement – When Doing More Is Not Enough
There have been many periods of change in health and human services ushered in by some external environmental factors:
- The creation of Medicare and Medicaid.
- New pharmaceutical agents.
- Medicaid home- and community-based services waivers.
- State block grants.
- Managed care.
- Olmstead.
- Medicare Part D.
- The Patient Protection & Affordable Care Act.
- Parity.
Each period of change has caused some disruption to the field. It is natural to resist change (as part of "grieving" a loss.)
When we move to acceptance - we can actually oftentimes see improvements. Is it possible to increase our ability to create better improvements - sooner?
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"I was reminded of the adage 'in the land of the blind, the one-eyed man is king.'”
- Do the operational basics well
- The consumer experience matters
- Understand outcome and performance data – and how to use them
- Don’t meet with health plan executives without preparation – no “cold calls” and “blind pitches”
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2018 North Carolina Releases Updated Plans For Integrated Medicaid Manag...
..."contract with five to seven full-risk, capitated tailored Medicaid health plans that will provide integrated physical, behavioral health, and pharmacy services along with some home- and community-based waiver services (HCBS) to individuals with behavioral health disorders (BH) or intellectual/developmental disabilities (I/DD)."
This looks like combination of leveraging:
- Risk-reduction (contracts)
- Accountability (outcomes based)
- Competition (multiple providers)
What else would you include?
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2019 The Challenge Of Making Best Practice Adoption Happen – The Payer P...
- How long does it take to gather meaningful evidence?
- How long does it take to understand what the evidence is telling us?
- How long does it take in update our initiatives to include the evidence?
- What do we do when something changes that invalidates our conclusions before they are implemented?
- How would we know that the change had occurred? When would we know?
What do you propose we do to create a better, faster and less expensive solution?
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2020 Why Unemployment Matters To Health Care Organizations
How does unemployment matter to education organizations. Are these organizations providing value to the employer or the employee? Who pays for the value? Do the unemployed need this value? Might there be an "educational insurance policy" that covers these costs? (might it be similar - but less expensive than COBRA?)
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2021 Building New Bridges – Behavioral Health & Law Enforcement
What are the most common factors that are directly correlated to performance below expectations? Who might be aware of these factors before either us or the manager of the performer?
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How might we shift from preparing people to be competent to assuring they are competent?
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2023 Navigating The Commercial Health Plan Market
How well is your organization performing? How do you determine the answer?
Would your employees, clients, and competitors agree?
Does it matter?
What percentage of organizations believe they are in top half of performers? top 20% #1?
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