Partners Behavioural Health Management is transforming the way that healthcare is offered, as Jamie Gianna says….
Transformation is a word that’s now becoming synonymous with any multitude of industry sectors worldwide. And while any transformation represents a game-changing journey for a business and its employees, few have the potential to be as significant as that which Partners Behavioral Health Management is undergoing. The North Carolina-based managed care organisation (MCO), established seven years ago, is now in the midst of a digital evolution journey that has the potential to change how healthcare in the United States is defined and paid for.
Jamie Gianna admits that it is, both an “exciting and scary time” for the organisation and the state of North Carolina. North Carolina pioneered a public Medicaid managed care system for behavioural health and intellectual/developmental disabilities in 2011. Next year, the state will move to an integrated healthcare approach for all individuals who rely on the public system for care. “We are right in the middle of developing and introducing many things that no one else has previously done before or even considered in terms of the way in which managed healthcare services are provided. In doing so, we are leveraging the very latest and most innovative technologies that will position us as a true leader in managed healthcare, both in North Carolina and beyond.”
Gianna is responsible for leading Partners’ digital transformation. He sits as a member of the Partners Operational Leadership Team, and rather succinctly describes his work as “trying to understand the organisation’s strategic targets based on the information and direction we get from the North Carolina General Assembly and North Carolina Department of Health and Human Services; while finding the right tools to fit and to meet those requirements.” In reality, Gianna is charged with strategic planning, leading mission-critical business initiatives and organisational objectives, and driving change that will result in improved customer service and go a long way towards achieving better healthcare provision for the population of North Carolina.
Partners is a public, regional managed care organisation, overseeing mental health, substance use disorder and intellectual and developmental disability (I/DD) services available through Medicaid, state and county funding. The organisation, Gianna explains, contracts with care providers to ensure that treatment options are available for eligible residents across the state. “North Carolina is quite a large state,” he says. “Its population is reaching close to 11 million, and one in every 10 is eligible for publicly-funded behavioural and I/DD managed care. But, the system right now is focusing on a portion of the person’s wellbeing, instead of focusing on the whole person, which is a big driver behind our transformation.”
The purpose of Partners’ digital transformation, explains Gianna, is a focus on understanding the overall health and healthcare needs of specific populations through leveraging technologies such as procurement platforms, predictive analytics tools, and the integration of the organisation’s services network so that it can manage the right services at the right time for its health plan members. “First and foremost, we recognise that we need to be very agile and mobile,” he notes. “The first target was driven from a population health and predictive analytics perspective, which focused on understanding what our total cost of care looks like, what do the state’s population and demographics look like, and how that fits into the wider financial and health strategies that we have. Having the ability to really get our arms around that data and turn it into something useful, meaningful and with real purpose had to be the first step.”
To meet this goal, two years ago, the organisation moved to the cloud – specifically, Office 365 – so that, at any place and at any time, anyone within Partners’ executive team could access all the data and information. The transformation journey is still ongoing, with Gianna outlining the steps. These steps include “sourcing a trifecta of procurement management tools, including tools for population health and predictive analytics that can create health risk scores, as well as portals for users and a platform that allows integration across North Carolina’s ‘healthcare universe’. We have found and applied all the tools we need,” he says. “We are now going to implement them – the first ‘finishing line’ is imminent.”