Tricia has over twenty years of experience in the human services field focused on being service oriented and assuring that Medicaid recipients receive quality care and services, specifically Developmental/Intellectual Disabilities and Behavioral Health populations. Trish’s operational experience includes building programs from the ground up, with fiscal and regulatory considerations; training and supporting customers in the […]
CCSI’s Tricia Williams, Senior Consultant, had the opportunity to attend this year’s Open Minds Strategy and Innovation Institute held completely virtual from June 1st to June 4th. The virtual program offered live sessions with question and answer opportunities and a virtual exhibit hall for news and presentations from partners and exhibitors. All sessions were recorded, and slide decks were available to Institute participants to either watch for the first time or re-watch to gain additional insights.
The COVID Pandemic was at the forefront of the programing with a focus on post pandemic activities. Some of the highlights included identifying new ways to embrace innovation and technology; the importance of data to drive decision making, strategic planning and performance; and how the pandemic has accelerated the implementation of Managed Care and Value Based Reimbursements.
Here are a few of her key takeaways from the institute:
Innovation after COVID
As Monica Oss shared during her opening remarks, “Innovation in health care has always been slow (with a 17-year lag from scientific validation of a promising practice to widespread adoption by consumers), the current pandemic has changed the expectations for innovation.”
Last year at this time, Telehealth practices were seen as innovative, and yet they are now considered an essential component of service delivery. The pandemic is changing our thinking from “how you stay relevant” to “how you survive”.
Each year Open Minds conducts a National Innovation Survey to understand how organizations are implementing new ideas with the purpose of creating value. What were some of the biggest innovative adoptions seen in the industry - telehealth, as expected; peer support specialists; medication assisted treatment (MAT) and primary care provider organizations and FQHCs making significant program investments for serving the behavioral health population.
Specialty provider organizations have and continue to struggle bringing innovative programming to the healthcare market, according to Open Minds National Innovation Survey. Not only are there very small increases in new program and or service adoption, the data appears to indicate that some programs are not finding success in the market and are being discontinued.
Importance of Data Driven Performance
Data to drive performance is not a new concept. And as we move from reactive practices to address the immediate needs created by the pandemic to the post pandemic altered service landscape, the question will remain- what is the value of the service related to the money spent on the beneficiaries? Many sessions asserted the notion that the looming budget deficits will make payers focus even more on value and boost the usage of managed care practices by Medicaid and Medicare leading to even more value-based reimbursement.
It appears that organizational leaders will want to become experts at understanding what data the health plans are looking for; gathering that data and managing their operations to improve that performance; knowing the performance of their competitors; and communicating those performance differences to health plan executives.
Six steps suggested by Oakland Community Health Network staff regarding the use of performance data to get new and better contracts included: be strategic; be consumer-focused; be prepared to go “at risk”; start small; communicate; and be persistent and prepared to pivot.
Development and implementation of Growth Strategies
We have been hearing the words nimble, pivot, agile and flexible for several months now, to describe how organizations need to approach altered landscape. There was no shortage of the use of these words during the Institute. Many speakers emphasized the need for leaders to have the ability to cope with and plan amidst ambiguity and bring calm during times of uncertainty. It was described that leaders will need to move teams steadily and step by step when the outcome is not yet known. These approaches will be essential to an organization’s survival.
Scenario-based planning, allowing an organization to pivot quickly will be key to recovery efforts. Taking the time to complete a portfolio analysis by conducting service line assessments, and thinking about what stays, what goes, and what must be added will be crucial in the financial sustainability of an organization.
Mergers, acquisitions, and collaborations, even with the competition, is gaining traction which in turn assists in expanding service volume, supporting referral exchanges, and assists in broaden staff expertise and skills.
Telehealth and other virtual technologies will need to be assessed and, in many cases, upgraded to adjust to the post-crisis regulatory environment and consumer demand; this is a question of survival as the competition is tough and getting tougher.
To close, it is evident that the telehealth phenomenon has been an “unplanned” reactive innovation. In essence, telehealth was adopted by force, generated by the pandemic forming a market restriction that prevented provider organizations from serving most of their consumer population unless they used telehealth. The question now is whether organizations can change their habits without a forced innovation and incorporate innovation into strategy development and execution.