A coalition of seven organizations has launched a new entity dedicated to improving patient health through a values-based model of care that focuses on behavioral health and related social determinants of health.
Dubbed the Integral Health Network of Southern Arizona LLC (IHNSA), the new organization is a clinically integrated network dedicated to providing closely coordinated behavioral health, primary care and social services. It was launched in mid-September.
IHNSA was conceptualized and organized by Blaze Advisors, a Wilmington, North Carolina-based population health management company, and Phoenix-based Banner University Health Plans.
“Taxpayers and communities are beginning to recognize that behavioral health has fallen under the radar,” Jill Lineberger, senior vice president of network development at Blaze Advisors, told Behavioral Health Business. “We have a lot of silent sick people out there.”
Lineberger compared IHNSA to an accountable care organization (ACO). It focuses on implementing the value-based care principles of strict care coordination among multiple providers and rewarding the best care outcomes.
Blaze Advisors provides a model and technology stack to support IHNSA. But IHNSA is independently operated by five member organizations: CODAC Health, Recovery & Wellness; Community Bridges Inc.; Helping Us Pursue Enrichment (HOPE) Inc.; Horizon Health and Wellness; and La Frontera Arizona Inc.
Blaze Advisors partnered with Banner University Health Plans to identify several underperforming cohorts with high levels of health care spending using their own technology stack.
Blaze Advisors then developed values-based care incentive plans focused on improving specific measures of health outcomes with Banner University Health Plans and IHNSA members. Those incentives are built into a shared savings reimbursement model that IHNSA receives as results are tracked over time.
Individually, the five IHNSA members still receive reimbursement from Banner University Health Plans for services rendered.
Many of those reimbursement arrangements are fee-for-service payments, Dennis Regnier, president and CEO of CODAC Health, told BHB.
“Any one of us can do a thorough assessment [of patients]Renier said. “But the reality is that it may take the services of two, three or more of these organizations to really reach what that individual needs and create the positive and valuable results that we all seek.”
IHNSA is based on the ONEcare model and technology, which includes a clinical intelligence engine (Lineberger called it the “brains” of the system) and a digital referral system.
Data from the referral system and other population health data are fed into the clinical intelligence engine to find potential gaps in the network, survey the patient community, and guide decisions by clinically integrated network members, individually and collectively.
The first ACOs were created in 2012, when 27 health care organizations partnered with the Centers for Medicare & Medicaid Services (CMS) to participate in a shared savings program for Medicare patient care. The ACO model itself was an outgrowth of the Affordable Care Act.
These organizations largely focused on physical health.
“The whole concept of forming a clinically integrated network for behavioral health providers and people struggling with mental health, substance abuse and social determinants of health is trying to bring attention to entire communities,” Lineberger said.
Value-based care models have slowly made their way to the forefront of behavioral health as the pandemic highlighted the connection between behavioral health and other aspects of health care.
the pandemic too showed how unevenly distributed the behavioral health workforce is found in many communities, making it difficult for many to access care.
Providers approved for CMS’s new ACO REACH program will seek to integrate behavioral health services into the primary care setting. The new program will start next year and run through 2026.
Even in the digital space, startups see a huge advantage in acting as coordinators and providers of behavioral health care.
Miami-based Brave Health got $40 million to expand its focus on value-based care to serve members of the Medicaid population.
