Understanding and Integrating Alternative Payment Models in I/DD Services

I had the pleasure of hosting a webinar this month entitled, “Understanding and Integrating Alternative Payment Methods in I/DD Services”. The webinar featured a panel of industry thought leaders with whom I’m sure most of you are familiar:

• Donna Martin, Director of State Partnerships & Special Projects, ANCOR
• Bonnie-Jean Brooks, President & CEO, OHI
• Kathleen Carmody, CEO, Institute on Public Policy for People with Disabilities
• Mark Davis, President & CEO, PAR

The panelists provided amazing insight on Alternative Payment Models (APMs), and I wanted to share my takeaways from the session.

• APMs are coming. All of our panelists were in agreement that APMs are here to stay and some even suggested that providers are being short-sighted if they don’t come to terms with that reality. This shift away from fee-for-service is being driven by CMS, and they are supporting quality versus quantity.
• Now is the time to get educated. Although APMs may not be gaining traction in your state right now as compared with others, now is the time to learn all things APM. There is a culture, language and set of values surrounding managed care that many associate with APMs. The better you understand those, the better equipped you will be to demonstrate your impact as an agency. Spend time figuring out how to make APMs work for you in your state.
• Know your value proposition inside and out. Data is key as we shift towards APMs, and taking a critical look at your agency is more important than ever before. Make sure you understand your cost per outcome. Who is involved? At what rate? Look at your organization critically and take a 360° view of your agency. Incorporate necessary changes into your strategic plan. These changes can touch on infrastructure, culture, etc.
• Capitalize on new and existing relationships. There are many relationships that you can start building or strengthening to prepare for APMs. Medicaid is typically driving this move toward APM’s, so make sure you get plugged in with your local Medicaid office. Start networking with providers that complement the services you provide. A few other relationships mentioned in the webinar were with financial institutions, the media, and families and individuals with disabilities.
• We’re all in this together; make sure you’re part of the change. Make sure you get a seat at the table and have your voice heard. Associations are a great way to stay plugged in and also have a unified voice for the provider community both on a state and local level. Advocate to make sure that not only providers are present at the table but families and individuals being served as well. You will want to get ahead of the change and get to the table while the state is developing RFPs and guidelines.