Lessons Learned from the Trailblazers Learning Collaborative: Steps to Getting Started on Health Care Contracting

The Aging and Disability Business Institute’s Trailblazers Learning Collaborative (TLC) brought together advanced aging and disability community-based organizations (CBOs) that have successfully contracted with health care entities to address common challenges experienced in securing contracts. The collaborative was comprised of two workgroups with the goal of developing strategies for approaching and engaging health care payers and providers to establish new contracts and agreements while growing existing relationships. In this blog entry, participants in the Business Institute’s TLC share their expertise to provide support and advice to the next generation of aging and disability CBOs seeking contracting arrangements with health care entities.

Do Your Research

Explore the local market to develop an understanding of the environment in which your CBO operates. Your CBO’s research should focus on learning which health care entities are doing business in your community, the services those health care entities offer, and if possible, how they are being evaluated on quality and performance. Learning about your local health care market will help your agency enhance its messaging and solidify its presence as a viable partner. This preliminary research will also help your CBO understand how it can stand out from the crowd when presenting its value proposition to a potential health care partner.

Let’s look at ways your CBO can learn about others that are operating in your market and what information health care entities may find important when considering your CBO as a potential partner. The Business Institute’s suite of Assessment Tools can help your organization conduct a competitor analysis and a Market Assessment. Additionally, watching the recording of the Business Institute webinar, Taking the Lay of the Land: CBO Market Analysis for Strategic Integrated Care Decision-Making, can provide insight from CBOs on surveying the market landscape.

Keep in mind that information gathering is not a one-time endeavor. It is important to conduct ongoing market research to stay informed of trends and how they may impact your agency’s position. Understanding the trends and the players in your market will help your CBO better prepare for negotiations related to new or existing contracts.

Knowing which quality metrics the health care entity your CBO has targeted is required to report will help your CBO determine which of its services can help improve your potential partner’s scores in certain quality improvement categories.

Your CBO should use its research to align your understanding of a health care partner’s pain points, membership needs, quality performance standards and ratings with the services your CBO offers. The next step to securing a contract with a health care entity is using the research you have gathered to inform meetings with potential health care partners. In some communities this can be easy, but it can be a challenge in others. Let’s explore ways your CBO can connect with health care professionals in your community.

Increase Your Agency’s Visibility

There are many ways your CBO can connect with health care entities and increase its visibility in the health care world, such as making connections at local conferences, community events and events hosted by local health care entities. Because many of these events have transitioned to virtual settings, they often require less of a time and financial commitment. An easy first step to making connections at events can be signing up for email lists that will enable you to learn about events and other news from potential health care partners. Another great way to engage with potential health care partners is by taking advantage of free networking opportunities—virtual conferences and events from health care leaders in your community or local health care association meetings.

Example:

Get in front of your audience! That’s what Partners in Care Foundation (Partners) CEO June Simmons did when she presented a webinar to health care executives during a seminar on transitions from acute to post-acute care. Simmons was able to describe the integral role Partners could play in helping health care entities manage these transitions. After the seminar, Partners sent an email to attendees with specific information about care transitions and how Partners could work with local health care systems. This follow-up email sparked the interest of a seminar attendee who worked in a local hospital’s case management department. Over time Partners cultivated this relationship—ultimately moving to formal business negotiations and resulting in a five-year care transitions contract. To learn more about how Partners grew a relationship into a contract, read How Partners in Care Foundation Leverages a Large-Scale CBO Network to Improve Health Outcomes for One of California’s Largest Health Plans.

Example:  

New Opportunities, Inc., (NOI) a community action committee in Connecticut, sought to establish a partnership with a local hospital but was initially unsuccessful despite numerous meetings with various hospital departments and grant funds that could help it pay for the service. By chance, a staff member was a neighbor of the chief of cardiology at a local hospital. After reaching out through that connection, NOI scheduled a meeting that led to the hospital committing to pilot NOI’s Hospital to Home Transitions of Care Program with four patients. The success of the pilot led to additional funding from the state of Connecticut to expand the program with the intention that, once success is proven on a larger scale, health care systems will be able to buy into it.

While meeting the right people to develop partnerships may take time and persistence, finding opportunities to connect with health care providers and payers in your community can lead to relationships that may lead to contractual partnerships. With a little bit of research and positioning, CBOs can be part of a health care landscape that is growing and evolving to better meet the needs of older adults and people with disabilities.