Yesterday marked the end of our week-long deep dive into all things ‘innovation’ as we closed out The 2020 OPEN MINDS Strategy & Innovation Institute. It was quite the week with 50+ faculty and over 700 attendees from across the country. There were some big takeaways that are going to shape my thinking in the months ahead. Here is my ‘top ten’ list…
10. Primary care organizations have made significant strides in the past year in adding innovative services for complex consumers but innovation within specialty provider organizations has slowed.
9. Providers organizations and payers CAN work together. Payers are looking for creative ways to meet consumer needs in times of crisis and beyond and welcome ideas and negotiation.
8. Frenemies are in! Collaborating, even with the competition, is gaining traction to expand service volume, exchange referrals, and work leverage broader staff expertise and skills.
7. There has never been a more critical time for portfolio analysis—now is the time to conduct service line assessments, and think about what stays, what goes, and what must be added.
6. Managed care and value-based reimbursement are becoming the norm—requiring increased investment in technology, an integrated approach to service delivery, as well as substantive data analysis and sharing to demonstrate results.
5. Telehealth and other virtual technologies must be 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.
4. Despite the challenges, there are many opportunities—home-based services, integrated primary/specialty care models for complex consumers, social support needs in Medicare Advantage plans, and the expected closure of 20% of nursing homes.
3. “Thinking differently” will define the organizations that succeed in recovery—focusing on the consumers but letting go of preconceived notions of structure, brand, model, and more.
2. Scenario-based planning has never been more important. Being prepared to pivot—quickly—is key to recovery. The “landscape” is still sorting out.
1. Right now, leadership matters the most—the ability to cope with and plan amidst ambiguity, to bring calm in the midst of uncertainty, and the ability to move teams step-by-step when the end point is not yet known.
In my closing remarks, Strategy In A Crisis – Staying Afloat Vs. Navigating: Keys To Planning & Managing For Recovery, I emphasized that every executive needs to keep scanning the horizon and keeping abreast of changes in the landscape; to be willing to think differently; to plan and replan, and work diligently on strategy implementation and organizational performance improvement. A tall order indeed.
To assist you and your team on the path to recovery, I’ve outlined the presentations of our “all star” faculty.
We discussed the current trends in serving complex consumer organizations—and how those trends shape future strategy:
Emerging Models & New Benefits For Individuals Dually Eligible For Medicare & Medicaid
In this keynote address, Allison Rizer, MHP, MBA, former vice president of strategy and health policy at UnitedHealthcare, took a deep dive into who dual eligibles are in their journey through navigating a fragmented, misaligned health care and social service system. Ms. Rizer discussed numerous emerging models that are intended to serve this population, as well as the potential role of health plans and provider organizations operating in this new world.
The health and human service field has historically lagged behind other markets when it comes to innovation adoption—but innovation could be the key to survival in our current landscape. In this session, I presented the results of The 2020 OPEN MINDS National Innovation Survey, which takes a deep dive into the variety of clinical innovations adopted by specialty provider organizations in the treatment and support of complex consumers. The survey includes data on the top adopted treatment and program innovations in 2020, and examines the trends in implementation between 2019 and 2020.
The Future Of Community-Based I/DD Services
Provider organizations caring for consumers with intellectual and developmental disabilities are in a state of flux—between navigating the COVID-19 pandemic, the move to managed care, shifting to home- and community-based services (among others). Michael J. Hammond, MSM, vice president, product strategy and partnership development at Optum Health discussed how provider organizations can navigate the challenges with best practices for operating in complex care management while meeting payer expectations in a managed care environment.
The Current Service & Financing Trends Affecting Children, Families & Provider Organizations
As provider organizations and payers are connecting physical and behavioral health to provide complete care for children and youth with medically complex issues, there are a number of new opportunities—and challenges—when supporting this population. In this session, OPEN MINDS Senior Associate Sean Klutinoty provides a big picture overview of market trends for services and financing for children and youth.
We reviewed the ‘best practices’ in strategy and leadership:
Creating A Sustainable Growth Strategy In A Rapidly Changing Market
Leading through uncertainty isn’t easy—but it’s not impossible. OPEN MINDS Senior Associate Ray Wolfe, J.D., discussed a best practice approach to creating a sustainable strategy in a disrupted health and human service market—from developing a new vision to putting your plan into action.
In any crisis, some leaders believe there is no time for planning—but planning should be the first action item on every executive’s list. In this session, I met with Charles Ingoglia, president and chief executive officer of the National Council for Behavioral Health; David Klements, president and chief executive officer of Qualifacts Systems, Inc., and Jon Wolf, president and chief executive officer of Pyramid Healthcare Inc., for a second discussion on the latest market data—and the essential actions executives need to focus on when it comes to ensuring stability, resiliency, and success in the new normal.
As behavioral health centers adjust to the new COVID-19 landscape, an integrated pharmacy can be an unexpected—and highly effective—ally. Genoa Healthcare’s Lilli Correll, vice president of payer solutions development, and Joy Holman, senior director of payer initiatives, discuss how dedicated pharmacies can help promote continuity of care and medication adherence, while giving centers a competitive advantage.
How Big Is Big Enough: Deciding When, How, Or If To Grow Your Organization
When it comes to mergers, acquisitions, and affiliations, growth for growth’s sake simply isn’t a viable strategy. In this seminar, OPEN MINDS Senior Associate Ray Wolfe discussed the necessary data needed to determine appropriate and sustainable growth. Mr. Wolfe was joined by Mike Lyons, general counsel of Mosaic, along with Hillsides’ Joe Costa, president and chief executive officer; Amy Ley-Sanchez, MSW, chief clinical officer, and Garret Zabel, director of strategy and innovation, who provided key insights and lessons learned when considering organizational growth opportunities.
Building The Leadership Team For Tomorrow: Balancing Skills & Culture
Now more than ever, it is essential for organizations to evaluate leaders, not only on their ability to play a specific role or on their skill set, but also on whether they are a fit in the workplace culture. That was the key takeaway from this session, where OPEN MINDS Senior Associate Drew Di Giovanni, MPH, FACMPE discussed how to create an engaged workforce that aligns with your organization’s culture, while leveraging best practices for recruiting and retaining top talent.
Improving Your Decisionmaking Skills: How To Be A Nimble Leader
In a rapidly changing market, leaders must have the skills to pivot quickly and make decisions under pressure. OPEN MINDS Senior Associate Ken Carr discussed how to improve your own decisionmaking ability by sharpening your strategic skills. He also discussed how leaders can better anticipate change and its impact on your organization.
Mergers, Acquisitions & Affiliations Readiness: What Does It Take?
The key to mergers and acquisitions is to not wait until it’s too late—when a merger or partnership is done right, it can bring expanded revenue through new consumers, geographical expansion of services, and new payer contracts. In this discussion, Mike Lyons, general counsel of Mosaic, and Cole Caruso, founder of Community Resource Network of Florida discuss their firsthand experience on identifying when a merger might be the right move—and how you can prepare.
Employee Engagement & Retention During COVID-19
The pandemic crisis is exacerbating the perennial issue of staff shortages in the I/DD services sector. This session included a strategic discussion with Stacy DiStefano, chief operating officer of Chimes International and Carl E. Clark II, president and chief executive officer of Devereux Advanced Behavioral Health, on new tactics and models to recruit, train, and retain an adequate workforce.
We took a deep dive into some of the “building blocks” of innovation and looked at innovative program models:
Innovation By Design: Capturing Value In Health Care
An executive team’s ability to lead in health care relies on an organization’s ability as a whole to act on innovative ideas. While this sounds easy, it takes times, resources, and discipline. That was one of the main takeaways from this keynote address, where Carl Clark, M.D., president and chief executive officer of the Mental Health Center of Denver provided insight into how the organization uses principles of Innovation By Design to leverage technology and achieve organization-wide innovation.
Creating & Managing The Clinical Models You Need For Value-Based Reimbursement
The common thread for all value-based reimbursement models is that the consumer is at the center of all care decisions and payment is based on clinical outcomes, not volume of services provided. As a result, organizations must have the processes, technology, and talent in place to support this type of reimbursement model. In this session, OPEN MINDS Senior Associate Drew Di Giovanni, MPH, FACMPE was joined by Dominick DiSalvo, MA, LPC, corporate director of clinical services at KidsPeace, for a focused discussion on evidence-based treatment plans for consumers with complex needs, and what is needed to build effective clinical models for VBR.
The saying “it takes a village” rings true when it comes to supporting children and youth with complex needs. That was highlighted in this session with Orchard Place Vice President of the PACE Center and Community-based Services Sonni Vierling, MA, who provided a case study on Iowa’s pediatric health homes, as well as key elements that build an effective team-based care infrastructure.
The Promise Of Mountain Health: The West Virginia Case Study
Supporting children with complex needs requires a trauma-informed, person-centered approach. In this session, Elizabeth Wendel, MSW, LSW, business project program manager at Aetna; Kevin Campbell, Model Author Family Finding of Center for Youth Connectedness; and Kathy Szafran, MA, LPC, executive director of Mountain Health Promise, Aetna, discuss the unique vulnerability of children in out-of-home care as well as how Mountain Health Promise aims to deliver better outcomes.
Children’s Health Homes In New York State: A Systems Perspective
Recent initiatives for health homes for children with medically complex conditions highlight the need to look at the whole child across the care continuum—this was exemplified in the discussion with Liberty Resources, Inc. Chief Executive Officer Carl M. Coyle, MSW. Mr. Coyle takes a deep dive into New York State’s Health Home model serving children with complex needs, as well as anticipated outcomes focused on improving care and lowering costs.
We discussed strategic approaches for identifying growth opportunities and diversifying service lines to increase revenue:
Interested in growing your organization but not quite sure where to start? In this session, Credible Behavioral Health’s Co-Founder and Chief Executive Officer Matthew M. Dorman will walk you through a proven methodology for identifying strategic opportunities to help you execute your growth plan.
Managing To A 10% Margin: Strategies For Increasing & Maintaining Your Organization’s Margins
Tracking profit margins is a key first step to answering critical revenue questions from, “Are we making money?” to “Are we providing the right services in our market?” OPEN MINDS Senior Associate Joe Naughton-Travers provided more insight into the various factors that affect your margins, as well as key insights into the strategic advice and tools necessary to manage to a 10% margin.
As consumer expectations change and new financial models emerge, it is essential for organizations to evaluate, modify, and develop new services to keep up with the changing landscape. In this executive seminar, OPEN MINDS Senior Associate Joe Naughton-Travers outlines everything you need to know about developing a new service line—from analyzing current services to determining strategic options for diversification.
We highlighted the importance of leveraging technology and becoming a data-driven, value-focused organization:
Amid the COVID-19 pandemic, the needs of health and human service organizations have shifted drastically—equipping staff with the right technology is key to keeping consumers and employees safe. In this presentation, AJ Peterson, vice president and general manager of CareGuidance at Netsmart; and Matthew Arnheiter, senior vice president of innovations at Netsmart discuss their perspective on how technology has been used to mitigate staffing difficulties during the pandemic. Mr. Peterson and Mr. Arnheiter were joined by Chief Information Officer of The Jewish Board, Uday Madasu, who discussed his experience firsthand in transitioning the organization to a virtual model without sacrificing efficiencies and ensuring security and compliance remain high priority.
Measurable Client Outcomes – A Provider’s Journey Continues
In a value-based world, proving meaningful client outcomes (and having the quantitative data to back it up) is key. In this presentation, two executives from Grafton Integrated Health Network—Jeremy Ulderich, director of education consultation and development and Scott Zeiter, executive vice president and chief operation officer of development—discussed the steps they have taken to ensure measurable client outcomes through Grafton’s Goal Mastery™ process and Foundation of Care™ clinical model.
Making Tough Decisions In Turbulent Times: 12 Steps To Creating Your Data-Driven Organization
Moving from a management team that relies on heuristics to an organization exclusively driven by data isn’t easy. In this session, I was joined by Carol Clayton, Ph.D., translational neuroscientist at Relias, for a deep dive discussion into the evolution of becoming a data-driven organization. We discuss the 12-step approach to becoming data-driven and case study examples of best practice performance reporting.
Demonstrating Organizational Value To Gain A Competitive Advantage
When it comes to being a ‘provider of choice,’ demonstrating your organization’s value is key. In this session, OPEN MINDS Senior Associate Drew Di Giovanni, MPH, FACMPE was joined by Nicole Lawson, Ph.D., deputy executive director and chief operating officer of Oakland Community Health Network and Joe F. Rutherford, MA, MBA, chief executive officer of Gracepoint, for discussions focusing on how their organizations have defined and demonstrated value (and gained a competitive advantage in the market as a result).
Leveraging Technology To Improve Services For Consumers With I/DD
As managed care organizations continue to demand increased levels of technology sophistication to reduce outcomes and improve quality of life, provider organizations need to keep up with the changing landscape to succeed. Delcie Bean IV, chief executive officer of Paragus Strategic IT, Inc., and Nick Filarelli, program director of Core Services of Northeast, TN, discuss the best way organizations can nurture a change in leadership mindset and a new service culture while making the case for infrastructure investments and quick adoption of technology.
Transitioning to VBR doesn’t come without its challenges, particularly when organizations are continuing to operate in the traditional fee-for-service payment model. OPEN MINDS Senior Associate Joe Naughton-Travers provided an overview on how to develop an organizational infrastructure to support this transition—with discussions from two organizations on their approach to operations and staffing for successfully managing both payment models. Mr. Naughton-Travers was joined by Centerstone’s Vice President of Quality, M. Brad Nuun, Ph.D., and Director of Healthcare Innovation, Mandi Ryan, MSN, RN; as well as Friendship Community Care’s Chief Executive Officer Cindy Mahan, and Executive Vice President of Strategy and Planning, Craig Cloud.
In a value-based world, it’s no longer business as usual for health and human service provider organizations. OPEN MINDS Senior Associates Drew Di Giovanni, MPH, FACMPE and Ken Carr review the key 
competencies needed for becoming value-based—from leadership and financial management to technology functionality and clinical performance optimization.
Health Plan-Provider Partnerships: Improving Care Through Collaboration
The move to VBR is driving payers and provider organizations to establish relationships—allowing both entities to leverage their combined experience, tools, technology, and data to deliver value. In this session, Alexsis Desrochers, vice president of value-based programs at Magellan Complete Care and Neha Patel, LPC, director of care delivery transformation, Southeast Region, Anthem, Inc. discuss their experiences in partnering with provider organizations, as well as the programs implemented to improve care and provide value.
And, as we look ahead, mark your calendar for our deep dives into management best practices, leadership, technology and analytics, and performance management:
- The 2020 OPEN MINDS Management Best Practices Institute: August 25 – 27, 2020, Newport Beach, California
- The 2020 OPEN MINDS Executive Leadership Retreat: September 14 – 17, 2020, Gettysburg, Pennsylvania
- The 2020 OPEN MINDS Technology & Analytics Institute: October 26 – 28, 2020, Las Vegas, Nevada
- The 2021 OPEN MINDS Performance Management Institute: February 10 – 12, 2021, Clearwater Beach, Florida
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