A coalition of seven organizations has launched a new entity dedicated to improving the health of patients through a value-based care model 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 delivering closely coordinated behavioral health, primary care and social services. It launched in mid-September.
IHNSA was conceptualized and organized by the Wilmington, North Carolina-based population health management company Blaze Advisors and Phoenix-based Banner University Health Plans.
“Payers and communities are starting to recognize that behavioral health went unnoticed,” Jill Lineberger, senior vice president of network development for Blaze Advisors, told Behavioral Health Business. “We have a lot of silent sufferers out there.”
Lineberger likened IHNSA to an accountable care organization (ACO). It focuses on implementing the value-based care principles of tight care coordination across several providers and rewarding improved care outcomes.
Blaze Advisors provides a model and a technology stack to support IHNSA. But IHNSA is independently operated by five member organizations: CODAC Health, Recovery & Wellness; Community Bridges Inc.; Helping Ourselves Pursue Enrichment (HOPE) Inc.; Horizon Health and Wellness; and La Frontera Arizona Inc.
Blaze Advisors teamed up with Banner University Health Plans to identify several cohorts that are not seeing good care outcomes and have high levels of health care spending using its own technology stack.
Blaze Advisors then developed value-based care incentive plans focused on improving specific health outcomes measures with Banner University Health Plans and the members of IHNSA. Those incentives are worked into a shared-savings reimbursement model that IHNSA receives as outcomes are tracked over time.
Individually, the five members of IHNSA 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],” Regnier said. “But the reality is there may need to be services from two, three or more of these organizations to actually hit at what that individual needs and to create the positive, valued outcomes that we’re all aiming for.”
IHNSA relies on the ONEcare model and technology stack, which includes a clinical intelligence engine – Lineberger called it the “brain” of the system — and a digital referral system.
The data from the referral system and other population health data are fed into the clinical intelligence engine to find potential deficiencies in the network, survey the patient community and guide decisions by the 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 caring for Medicare patients. 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 individuals struggling with mental health, substance abuse, social determinants of health is trying to bring whole communities into care,” Lineberger said.
Value-based care models have slowly worked their way into the forefront of behavioral health as the pandemic has highlighted the connection between behavioral health and other aspects of health care.
The pandemic also demonstrated how inequitably distributed the behavioral health workforce is in many communities, making it difficult for many to access care.
Providers approved for CMS’ new ACO REACH program will seek to integrate behavioral health services into the primary care setting. The new program will begin next year and run into 2026.
Even in the digital space, startups see major upside acting as a coordinator and a provider of behavioral health care.
Miami-based Brave Health landed $40 million to expand its value-based care-focused approach for serving members of the Medicaid population.
Companies featured in this article:
Banner University Health Plans, Blaze Advisors, Integral Health Network of Southern Arizona
