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Defining Your Value:How to Develop and Use Your Value Proposition

Wednesday, May 15th

12-1pm

National Council for Behavioral Health

Montefiore Medical Center

Northwell Health

New York State Office of Mental Health

Netsmart Technologies

Today’s Presenters

Maura Gaswirth, LICSWDirector, Training and Technical Assistance,National Council for Behavioral Health

Mindy Klowden, MNMDirector, Training and Technical Assistance,National Council for Behavioral Health

https://www.thenationalcouncil.org/wp-content/uploads/2019/03/Value-Proposition-Guide.pdf

Now Available!

7 Steps to Crafting Your Value Proposition

Step 1: Understand What is Meant by

“Value Proposition”

Step 2: Conduct a Stakeholder Analysis to Understand Who

Your Value Proposition is For

Step 3: Identify and Collect What Data You Will Need to Build Your Value

Proposition

Step 4: Craft Your Actual Value Proposition

Step 5: Develop Your Communications Strategy for Your Value Proposition

Step 6: Enhance Your Value

Proposition Through Partnerships as

Needed

Step 7: Update and Tailor Your Value

Proposition

✓Explains what benefit your organization

provides, for whom, and how you do it

uniquely well.

✓Builds the case that you are better positioned

to meet the community’s need than your

competitors.

✓A living document that can be updated as

needed and is tailored to different audiences.

Step 1: What is a Value Proposition?

Participant Poll

Where is your team currently in developing your value proposition?

• Already sharing with payers.• We have a value proposition, but are unsure

on next steps.• We are currently developing our value

proposition.• Not sure where to start.

Crafting a Value Proposition Sample: “The Center for Behavioral Health (CBH)”

Who do you need to influence, and

what do they care most about?

Step 2: Stakeholder Analysis

✓Accountable Care Organizations✓Independent Provider Associations✓Other current or potential partners

✓Policy makers✓State and County Administrators✓Managed Care Organizations ✓Commercial payers✓Potential clients

✓The “Center for Behavioral Health” sees 10,000 clients annually, and 85% have Medicaid.

✓The State contracts with Managed Care Organizations and provides much flexibility.

✓XYZ Health Group is the largest Medicaid Managed Care Organization in the region.

Conclusion: XYZ Health Group is the most important partner to influence if CBH wants to pursue a value-based contract.

Who do you need to influence?

CBH’s Stakeholder Analysis

What do they care most about?

✓Like all MCOs, XYZ Health Group is interested in market share.

✓XYZ Health Group is committed to reducing the total cost of care through appropriate utilization patterns.

✓XYZ Health Group has been piloting value-based payment models including pay-for-performance, bundled payments and shared savings.

✓They like predictability and appreciate when providers know the utilization patters, morbidity rates and demographics of their clients.

How does CBH know all of this? Intelligence gathered from the MCO procurement process, literature review, stakeholder meetings, and previous contracting meetings.

Sample Stakeholder Analysis

Step 3: Identify and Collect DataTaking what you learned from the stakeholder analysis, begin compiling the data that will be most compelling to your audience.

This may include:

✓Reductions in emergency department utilization, hospitalization and/or hospital readmission

✓Access data (e.g., how quickly patients get seen from time of referral)

✓Physical and behavioral health outcomes

✓Patient satisfaction

✓Cost data

CBH’s Data Collection Plan

✓Data that demonstrates market penetration. Source(s): EHR

✓Data that demonstrates CBH is having success at reaching clients within 7 days post-hospitalization. Source(s): regional health information exchange, claims data, EHR

✓CBH cost data. Source: claims management system, program budget.

✓Client success story. Source: care coordinator to collect anecdotes from clients.

Key Elements:

✓WHAT community need do you address?

✓WHOM do you serve?

✓HOW do you meet the community’s needs?

✓WHY are you better than your competitors?

Strong value propositions are relevant, specific, and CREDIBLE.

Step 4: Craft Your Actual Value Proposition

Crafting CBH’s Value Proposition - Sample Outline

What community need do you address?

• Community members with behavioral health disorders lack access to appropriate services. Some are using the hospital as their primary source of care, and their post-discharge care is not being well coordinated.

Whom do you serve?

• CBH serves adults with serious mental illness and/or substance use disorders. Many also have co-morbid chronic health conditions. 79% of CBH’s clients have coverage through XYZ Health Group.

How do you meet the community’s needs?

• Licensed clinicians provide an array of psychiatric and counseling services using validated screening tools and evidence based treatment. CBH has a new follow up care program targeting clients with serious mental illness who have been hospitalized for psychiatric reasons.

Why are you better than your competitors?

• CBH is outcomes-oriented and has strong data analytics capabilities. We have data that show we can get clients seen within 7 days post-hospitalization at a higher rate than the MCO average. We are efficient and keep overhead costs low.

Insurance Coverage of CBH Clients

79%

11%

5%5%

XYZ Health Group

Other MCO

Medicare

Uninsured

CBH Rates of 7-Day Follow-Up

45%50% 50%

70%

0%

10%

20%

30%

40%

50%

60%

70%

80%

MCO Average NCQA Benchmark CBH Rate Prior toProgram

CBH Rate Year 1

CBH Program Costs – Per Member Per Month

Service Hourly CostAverage

UtilizationTotal

Care Coordination (Masters level) $150 2 $300

Prescriber (MD or NP) $330 1 $330

Outpatient therapy (Masters level) $150 1 $150

Community support (Peer or Bachelors) $55 2 $110

Sub-total $890

Administrative costs (includes occupancy) 18% $160

Total $1,050

The Center for Behavioral Health (CBH) has provided evidence-based mental health since 1978. Eighty

four percent of CBH clients have Medicaid managed care through the XYZ Health Group. We provide a

continuum of recovery-oriented services that help ensure adults experiencing a serious mental illness or

substance use disorder, can lead healthier, productive lives. All too often, adults with (SMI) lack

adequate community-based treatment and use the hospital as their primary source of care, and their

post-discharge care is not being well coordinated.

At CBH licensed clinicians provide an array of services including: psychiatric care and medication

management; individual, family and group counseling services; nurse care management and care

coordination services; wellness services focused on whole-person care; and peer support. CBH also

specializes in post-acute care and has successfully piloted a 7 day follow program to ensure appropriate

coordination of care for adults with SMI who have been hospitalized for psychiatric reasons.

We are unique because of our strong organizational philosophy of being patient-focused, outcomes

oriented, and cost-effective. We use validated screening tools and track key performance indicators. The

impact of our services is clear. Last year:

➢ Seventy percent of clients referred to CBH following psychiatric hospitalization were seen

within one week, compared to the MCO average of 45%.

➢ Eighty percent of CBH clients reported they were satisfied or highly satisfied with our

services.

➢ Eighty two percent of revenues went directly to patient care.

“Kelly” is one of many clients whose lives have been changed by CBH. According to Kelly, “About a year

ago I was having severe mood swings and gaining a significant amount of weight. I did not want to get

out of bed and missed so many days of work that I lost my job. I was in and out of the hospital and felt

like I did not have anywhere else to turn. Fortunately, CBH’s Care Coordinator met with me upon my last

hospital discharge and helped me connect with their services. I started meeting with a Psychiatrist as

well as a social worker. I have not been back to the hospital in almost a year now. I feel like CBH turned

my life around. For the first time in a long time, I have hope for a better future.”

With your support, CBH can reach more clients like Kelly and help reduce unnecessary readmissions.

Step 5: Develop Your Communications Strategy

✓Think of how you will communicate your value proposition. What will be most effective for your audience?

✓Share quantitative data through charts, graphs, or other visual representations.

✓Share patient stories that demonstrate your success!

✓Incorporate your value proposition into:• Presentations

• Collateral materials such as fact sheets, newsletters, brochures

• Formal written proposals

CBH’s Communications Strategy

✓CBH’s contract as part of the XYZ Health Plan Network is up for renewal in 3 months.

✓CBH determined the best strategy for communicating their value proposition would be to develop a white paper and also request to do a formal presentation at a contract negotiation meeting.

✓CBH incorporated the quantitative data they had collected and the most compelling patient story they had collected.

Tips for Successful Contract Negotiations

Know your costs.

Remember organizations are run by people. Meetings are about building a personal relationship.

Prepare to share your value proposition and all relevant data.

Bring the right people to the room.

Look for the win-win.

Understand what is important to the payer per your stakeholder analysis.

Know when your contracts can be renewed or renegotiated.

✓Partnerships can enhance your value proposition by expanding your scope of services, reaching a larger patient population or bringing in additional capacity and core competencies.

✓If you decide to partner, ensure you share a common vision, clearly defined roles, agreements in writing, and aligned value propositions.

Step 6: Enhance Your Value Proposition Through Partnerships

Participant Poll

Do you think CBH could enhance their value proposition through a partnership?

• No- they have what they need.• Yes- they lack access to hospital cost and utilization data. A

partnership with the local hospital would enhance their value proposition.

• Don’t know.

CBH’s Partnership Strategy

✓CBH determined it would be more effective in reaching clients within 7 days post hospitalization by formalizing their partnership with the local hospital.

✓They created a Memorandum of Understanding and written protocol for information exchange.

✓CBH decided it would be strategic to invite the hospital to their upcoming contract negotiation meeting with XYZ Health Plan.

Step 7: Update and Tailor Your Value Proposition

✓Determine a process for reviewing and updating your value proposition based on emerging needs, new partnerships, current data and/or accomplishments, significant changes within your organization, changes to your costs or within your external health care environment.

✓Identify the person(s) or team who will be responsible for updating your value proposition, how often it will be reviewed and updated and how you will engage leadership and staff in this process.

✓Update your value proposition in accordance with your process.

Questions?

Exemplary Practice Story Campaign

Why Write a Story?

CMS Seal of Approval as an Exemplary Practice

Inclusion of story in CMS’s Exemplary Practice Database

Potential to be selected to participate in CMS’s Transforming Clinical Practice Initiative

Marketplace in August 2019

Poster or presentation at the Care Transitions Network end of project celebration

Things to Keep in Mind When Writing

• Own your story through use of a first-person voice.

• An exemplary practice performance story is different than an improvement story. It defines what your value is, rather than how you got there.

• Focus on results rather than the journey.

• Be clear about the size and characteristics of the population being managed.

• Acknowledge significant progress toward a population management approach.

• Use performance on process measures and clinical guidelines to describe performance, but also consider and include information on next steps to fully capture value.

Things to Keep in Mind When Writing

• Use population targets that set benchmarks.

• Draw data from the management information systems driving performance.

• Combine the use of text and tables to present performance with clarity.

• Make the numerical statements of performance clear and complete.

• Note patient ownership of and satisfaction with performance.

• Note payers purchasing the exemplary practice’s performance.

Technical Assistance

• One-to-one support on story development and drafting with National Council communications experts

• In-person, virtual training and support on crafting value propositions and developing your exemplary practice story

• Assistance with visual aspects of story

Next Steps

Review the template with your team and

start writing

Review your data

Submit your story by June

15th for review and submission

Questions?

Upcoming Webinars

Event Date and Time

What Non-Prescribers Need to Know About Simultaneous Use of Multiple Antipsychotics

Tuesday, May 21from 12:00-1:00pm

Health Information Technology and Behavioral Health Performance Metrics

Wednesday, May 28 from 1:00-2:00pm

Practitioner Interventions: Assessing, Documenting and Addressing Medication Non-Adherence

Thursday, May 29from 12:00-1:00pm

Organizational Practices and Policies to Support Medication Adherence

Tuesday, June 11from 12:00-1:00pm

Upcoming In-Person Events

• Payer Forums hosted by MCTAC and the Care Transitions Network• New York City – Tuesday, June 4th

• Plattsburgh – Thursday, June 6th

• Buffalo – Wednesday, June 12th

• Syracuse – Thursday, June 13th

• Albany – Friday, June 14th

• End of Project Celebration• Tuesday, August 13th

We are here for you!

Contact:

Mindy Klowden, MNM

Director, Training and Technical Assistance Mindyk@TheNationalCouncil.org

Maura Gaswirth, LICSW

Director, Training and Technical AssistanceMauraG@TheNationalCouncil.org

Thank you!www.CareTransitionsNetwork.org

CareTransitions@TheNationalCouncil.org

The project described was supported by Funding Opportunity Number CMS-1L1-15-003 from the U.S. Department of Health & Human Services, Centers for Medicare & Medicaid Services.

Disclaimer: The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.