Freshly brewed! ☕ Coffee & Contracts today was chock full of Financial Modeling for Community Care Hubs (CCHs) and #ManagedCarePlans.
Here's a summary of the coffee grinds from the breakout session I moderated:
HOW ARE YOU ENSURING ROI FOR HEALTH PLANS AND PROVIDERS? One of the most straightforward ways is to show per member per month (PMPM) net cost savings for health plans. But other options exist! As one attendee put it, "There are multiple audiences our programs are pleasing." e.g. by opting into Michigan's Food Access programs, Health Plans positively impact their membership growth rate through increased auto-assignment. Also, great CCH partnerships also help hospitals reduce length of stay. In short, take a broad view of all the financial $ upsides that partnership with your CCH brings and know how to quantify them.
CASH IS KING. Or, more specifically, plan your cashflows! In multi-year contracts, it's not uncommon for year 1 to be in the red. Turning the positive cash flow corner may not happen till Yrs 2 or 3. Make sure you plan your cashflow to cover the upfront investment.
QUALITY IS BUILT FROM THE GROUND UP. While CCHs may take the lead on forming and negotiating partnerships on behalf of the CBOs in their network, they can only do a great job with great inputs. CBOs! Let them know information about pricing, capacity, and other issues that will help plan for the best contract.
YOUR FINANCIAL MODEL IS FOR YOU, AND ALSO NOT FOR YOU. Yes, all agree that the financial model for CCH partnership with Health plans is critical for managing sustainable growth. But, its also critical to check assumptions and facilitate negotiations with health plans. Internal + external use case. Deana Smith, Gudrun Bossman, and Jennifer Black from Center for Health and Research Transformation (CHRT) CCH generously shared their funding model which evidenced this approach.
WORTHY SHARE: New social care-healthcare contracts are demonstrating value. Early results from Ohio State Hubs have shown that addressing Social Drivers of Health (SDoH) led to an 11% decline in Emergency Dept. utilization.
Special thanks to the collective wisdom of our session that produced these insights. Add your thoughts!
Camden Coalition Partners in Care Foundation Partnership to Align Social Care #managedcare #socialcare #SDoH #HRSN Jeffrey Hill Danielle Gritters Jessica Kinsey Eric McNair Scott Meredith Fratantonio, MHA, MBA, LSS, CMPE, PHR Debra Nauls-Freeman Ray Manahan, MHA, PMP