Payer-Provider Collaboration: The Value Of Data Sharing For Whole Person Care

Sponsored By Care Management Technologies The relationship between payer and providers is shifting. Payers are establishing greater expectations of providers for integrated care, including care coordination and care management activities that have typically been the functional responsibility of the payer. Provider reimbursement is being tied to performance metrics such as overall health outcomes, functional life skills improvement and quality of care. These shift are fraught with challenges and risks. Collaboration and trust between payer and provider are key. Hear from one payer/partner collaboration – The Sandhills Center, a fully capitated behavioral health organization (BHO), and Carter’s Circle of Care, a fully service Federally Qualified Health Center (FQHC)/Community Mental Health (CMHC) service agency about their work to make integrated care a reality in Grennsboro, North Carolina. The audience will learn:

• How and why the Sandhills Center set expectations for network providers to institute and delivery integrate care services using data to drive performance
• The decision points for sharing full claims data with the provider to support this effort and the challenges/risks they mitigated to do so
• How Carter’s Circle of Care operationally began to more fully provide integrated care services
• The challenges of the “gift of data” experienced by Carter’s Circle of Care and how they are addressing them
• The outcomes goals for 2017 as a result of the collaboration.

Also presenting will be Courtney Cantrell, Ph.D., former NC Mental Health, Department of Health and Human Services (DHHS), Developmental Disabilities and Substance Abuse Services (MH/DD/SA) Director who will offer her perspective of state agencies desires for payer/provider collaborations and her view from inside and outside DHHS. Dr. Cantrell now works for CMT, a Relias Learning Company and supports the Sandhills-Carter’s Circle of Care initiative.