Strategic Growth and Business Relationships Course Three – June 7 Presented by Patrick Gauthier. Overview. Review Causes and Conditions Discuss Strategic Implications for Business Development Review Options Affiliation, Association Joint Venture, Strategic Partners Merger Acquisition
Course Three – June 7
Business Operations and Process
Business Infrastructure and IT
For the unprepared, The Winds of Change can appear chaotic and as disruptive
…or they can appear as a dynamic, inter-dependent series of incremental improvements to our health care and health insurance systems.
The difference is preparation.The difference is planning.
All plans in the health insurance exchange will be required to adhere to the provisions of the Wellstone/Domenici Parity and Equity Act.
Medicaid enrollees, including newly eligible childless adults, will receive adequate health coverage, including MH/SUD coverage.
MH/SUD will be included in chronic disease prevention initiatives.Reforms
Prevention and treatment providers to be eligible for community health team grants aimed at supporting medical homes.
Expanded Medicaid coverage for all Americans below 133 percent of the federal poverty level (est. 16 million)
Health insurance exchanges created for individuals and small employers to pool risk and purchase insurance (est. 16 million).Reforms
Structure, Governance and Shared Savings
IT Infrastructure and Data Management
Population Health Home
Rx & Lab
82 million are in self-insured plans
CHIP and Medicaid managed care plans
460 health insurers and 120 Managed Behavioral Healthcare Organizations (MBHOs)Parity Impact
Counties and Cities
75% - 90%
Corrections & Courts
Health Insurance Exchanges
32+ Million Uninsured
Medicaid Managed Care Plans
Housing & Jobs
Standards & Science
Managed care and utilization review
Medication Assisted Treatment (MAT)
ACOs and Patient-Centered Medical Home (health home) models
Population Health Mgmt
Standardization and normalization of data, terms and toolsWhat to Expect
Vertical integration (“one-stop shop”)
Horizontal integration (strategic partnerships)
New approaches to reimbursement like Global Payments
New populations to serveOpportunities for…
Vision – what will you become?
Mission – how will you become what you envision?
Goals – what incremental achievements will enable you to satisfy your mission?
Objectives – what tactical steps will enable you to meet your goals?
Address outsourcing and the need for periodic expertise
Commit to Performance Mgmt
Keep distractions and competing priorities to a minimum
Hold people accountable
Align efforts so time and energy are not wasted
Provide reinforcements, encouragement and rewards (recognition)
Become Learning Organizations
Innovate and grow from your Core Competencies
Encourage some risk-taking, experimentation and tolerate mistakes
Tension will exist between:
Paradigms: past, present and future
People vying for roles
Short and long term needs
Profits and investments in the future
The team and the individual
Dissent and agreement
“Business” and “Recovery”
The “way we’ve always done it” and innovation
The challenge is one of making the tension
creative and productive