Last week, we had our first annual OPEN MINDS Children’s Services Executive Summit, and my collaborator and colleague, OPEN MINDS Senior Associate Howard Shiffman and I weren’t quite sure what to expect. We’ve both been working in the children’s services space for a while, and we’ve seen a lot of change. What we found was great energy for finding new opportunities as part of that change—for new strategies, for new services, for new reimbursement models, and for new business models—among the participating executives from 18 states.
The “what” driving that change was the focus of our opening session, The Five Key Drivers Of Change In The Children’s Service Market, during which we looked at what is happening in health and human services broadly, and the unique twists in serving children.
Value-Based Reimbursement (VBR) & Performance Management—We’re seeing a shift in how children’s services across the spectrum of care are being financed and managed, with a continuous push towards models focused on value. In health care, new services (such as autism treatment) and populations (like children in foster care or children with intellectual/developmental disabilities) are being moved to managed care with value-based reimbursement (see Making Foster Care & Managed Care Work and Managed Care Comes To Social Services – Some Advice From The Field). In child welfare and juvenile justice, we’re seeing more competitive performance-based contracts and social impact bonds specifically targeted at justice-involved youth or children in the foster care system (see Social Impact Bonds: Over $166 Million In Funding & 20 Programs).
New Technologies, Both Analytic & Treatment—Success in a VBR environment demands a greater reliance on data and analytics to monitor outcomes and manage populations. To compete for value, organizations will need a data-driven culture fueled by a technology infrastructure that supports performance. Treatment technologies are also a big part of the value equation as we move away from fee-for-service and cost-based reimbursement. To be successful with VBR, organizations must deliver a better consumer experience with high-quality services at the lowest possible cost (see Why Your Tech IQ Will Determine Your Success In A Value-Based World).
New Competition—Children’s services aren’t immune to the overall market consolidations we’re seeing throughout health care, with mergers and acquisitions creating bigger organizations, integrated networks, and new competitive forces (see Are Health Plans Your New Competition?). With the shifting market models, there is an added pressure from private equity, which has focused recently on the children’s service space—including child care, special education, mental health, autism, and I/DD (see What Investors Are Looking For In The Complex Consumer Space). The children’s service provider organizations that will be the most successful in competing will be those that are open to collaborations and partnerships, can deliver on great customer service, are clinically “cutting edge” and driven by best practices, and finally, those that are “high performing” on the VBR contracts payers demand.
Workforce Management Issues—Just like the wider health and human service market, child-serving organizations are seeing changing demographics and cost pressure create major workforce shortages. This has put many organizations into a mode of “constantly seeking” both child psychiatrists and direct support professionals. Overcoming this will require organizations that can revamp both their recruitment practices for new employees and their engagement strategies once they have added new employees to the team.
Changing Philosophy In The Children’s Marketplace—What is the new philosophy in this space? The “whole child” perspective is knocking down the traditional silos that have kept physical health, behavioral health, long-term supports, and social service needs separate. Payers are looking for a holistic approach to caring for children and the family unit that coordinates the delivery and allocation of services for the greatest benefit of the consumer in the most home-like setting possible.
What do these changes look like in the field? Check out our recent coverage of some of the big news in the children’s health and human service market:
- Apricot Case Management Software Receives $59 Million Investment
- ACF Launching EBP Clearinghouse For Family First Prevention Services Act
- Woods Services Opens I/DD-Focused Patient-Centered Medical Home For Keystone First Members
- The Arc Of New Mexico Launches Sexual Assault Services For People With Intellectual Disabilities
- Maine Medicaid To Cover Youth Psychiatric Residential Treatment Facility Setting
- California Medicaid Launches Whole Child Model Program
- Texas Selects 2INgage For Region 2 Foster Care Contract
- Pennsylvania Auditor General Recommends 28 Changes To Improve Child Welfare System
- Children’s Hospital Colorado & Anthem Launch Pilot Child-Focused Value-Based Program
- Otsimo Expands Autism Education App In U.S.
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For more on the overall shift to value in health and human services, be sure to join John F. Talbot, Ph.D., Chief Strategy Officer at Jefferson Center for Mental Health, and OPEN MINDS Advisory Board Member, on September 19 at The 2018 OPEN MINDS Executive Leadership Retreat for his session, “The New Leadership Challenge: Culture & Change Management In A Value Based Market.”