Perspectives: Making the Case for Effective Health Care and CBO Partnerships
Read Dr. Chernof’s perspectives on the importance of there being effective partnerships between health care entities and community-based organizations.Date Updated: 08/06/2015
In the next decade, health care payments will substantially transition from fee-for-service or fee-for-utilization risk (the current capitation model) to fee-for-outcomes. To succeed, health plans and their contracted networks must develop far more robust care coordination programs and broaden their networks to include a comprehensive set of non-medical, community-based service providers. Developing these networks is not easy. There is a fundamental question as to whether to delegate these extended services to contracted providers, or retain the development and management of these extended provider networks. Health plans are still learning the types of services they may want to contract for as well as developing perspectives on network adequacy, quality oversight and data sharing. What is clear is that community-focused care coordination, particularly at times of transition like hospital to home, is the lynchpin to better care at lower costs. Extending current network models to include community-based providers that can deliver this robust care coordination and judiciously manage specific community-oriented services is the immediate challenge.
For community-based service providers, this evolution in the delivery of health care presents unique challenges and opportunities. Working with health plans requires re-imagining services as specific products that solve challenges faced by the medical delivery system. These relationships represent a new revenue opportunity for community-based providers, yet are not a replacement for traditional funding for aging services. Vanguard community-based organizations, those we believe are ready for this new role and have care coordination in the center of their model, are in a position to be effective health plan partners…