Understanding Umbrella Hub Arrangement Value Proposition Workshop
This resource provides guidance on outlining the services and supports partners of an umbrella hub arrangement can expect to receive, known as the value proposition. Developed for umbrella hub organizations, it assists in building business strategies and engaging with partners effectively. By understanding the value proposition, such as what makes the umbrella hub attractive to partners, organizations can better communicate and recruit partners for sustainability.
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JULY 2022 Umbrella Hub Arrangement Value Proposition Workshop
Value Proposition Workshop Description WHAT is this resource? This deck provides instructions and examples on outlining the list of services and supports partners of an umbrella hub arrangement (UHA) can expect to receive from the UHA (also known as the value proposition). WHO is this resource for? This resource has been developed by NACDD and Leavitt Partners for umbrella hub organizations (UHOs). The resource may be useful to the project team responsible for building the business strategy for the UHO as well as for staff responsible for marketing, communications, and partner engagement. WHEN would this resource be helpful? It is recommended UHOs develop and outline the various value propositions of the UHA during planning phases prior to UHA operationalization. It is also useful to revisit value propositions before engaging with potential partners of the UHA. HOW should this resource be used? It is recommended the value proposition be used during group planning sessions when developing the UHA business plan or business strategy. WHY should this resource be used? Partners including subsidiary organizations, state health departments, payers, and referring organizations are essential to the success of the UHO. In order to build relationships with partners, each UHO must be able to articulate the reasons why partners should choose to engage with its UHA. 2
Understanding the UHA Value Proposition Building a sustainable UHA is dependent on identifying, communicating, and recruiting partners. Potential partners may include subsidiary organizations, payers, referral partners such as physician practices, state health departments, 1705 organizations, and others. Understanding the value proposition, what makes the UHA attractive to partners, is essential to effectively communicating with those partners. By creating and illustrating the value proposition during partner recruitment, the UHO can better understand their partners needs and create effective strategies for addressing those needs. The value proposition is one of the four key components of the UHA Business Model, as illustrated on slide 4. Developing a project plan that encompasses each of the four components can assist in streamlining operationalization of the UHA. 3
How to Use the UHA Value Proposition Workshop Slide Deck There are four sections in the slide deck. Each section focuses on a different partner for which the UHA needs to develop a value proposition. Partners include: (a) Payers, (b) Subsidiary Organizations, (c) Referral Partners, and (d) Funding/Convening Partners (such as state health departments or 1705 organizations). Each section contains: (a) a list of possible pain points experienced by each partner, (b) a list of UHA value propositions to address the pain points, (c) an example table demonstrating how users can develop a value proposition specific to their organization, and (d) a blank table to populate with unique or additional value propositions. After reviewing the pain points and value propositions for the potential partner, users are encouraged to adapt the value proposition and action items to their unique situation. Note: The information in this deck reflects pain points and value propositions identified by existing UHOs, however, it is not reflective of all possible pain points and value propositions. Additionally, the example tables on slides 9, 14, 20 and 25 illustrate potential opportunities UHAs could utilize to appeal to partners and may not be reflective of current UHA processes. Users are encouraged to treat this resource as a starting point for developing their value proposition and include additional items as relevant to their unique landscape. 5
UHA Value Proposition Payer Focus 6
Pain Points for Payers Administrative Burden Administrative Burden Engagement with multiple community-based organizations (CBOs) is resource intensive Outcomes/Metrics Outcomes/Metrics Engagement/Retention Engagement/Retention Challenges in reaching priority populations Pandemic-reduced capacity Limited program availability Limited virtual options Metrics are not being met due to low participation Missed opportunity for improvements to beneficiary health outcomes Cost Cost Health Equity/SDOH Health Equity/SDOH Poor completion rates increase the likelihood of a diabetes diagnoses and higher cost of care Priority populations not receiving the services they need Challenges in addressing barriers to access 7
UHA Value Proposition for Payers Administrative Burden Administrative Burden UHO provides administrative support to CBOs UHO may hold a single contract Outcomes/Metrics Outcomes/Metrics Engagement/Retention Engagement/Retention Improved outcomes with UHA in charge Access to a one-stop-shop for multiple services UHA expands network, availability, and access UHA can tailor the lifestyle change experience for populations of focus of metrics Increased participation supports better health outcomes Cost Cost Health Equity/SDOH Health Equity/SDOH Improved enrollment and completion improve return on Increased resources to address barriers to accessing the National DPP lifestyle change program Partnership with organizations that are in priority communities investment Achieve cost savings related to providing an intervention at the prediabetes stage 8
UHA Value Proposition: Payers Potential Options Pain Point Value Proposition Specific Actions Administrative Burden UHO holds a single contract with each payer (on behalf of UHA and subsidiary orgs) UHO provides technical assistance and streamlines administrative support removes need for subsidiaries to undertake high-resource processes (such as MDPP application and Medicaid provider enrollment) Understand payer contracting Include specific language in contracts that accounts for the dynamics/relationships within the UHA Perform regular data/enrollment evaluation Set standards and parameters around coach training and outreach processes Outcomes/ Metrics UHA helps to meet internal payer requirement for inclusion of prevention programs in covered costs UHA provides aggregated/normalized datasets via aggregated data from all subsidiary organizations UHA documents metrics which payers may be responsible for Tie together data from multiple interventions Perform data analytics and evaluate performance metrics on both beneficiaries and interventions Engagement/ Retention UHA assists with retention of lifestyle coaches (in turn addresses the retention of members in the program) UHA provides broad access to Medicaid beneficiaries via widespread subsidiary organization involvement Lifestyle coaches from within the UHA may be used to fill gaps for other organizations (i.e., large cohorts) Provide National DPP lifestyle change program master training in- house for lifestyle coaches (local and unique to populations) Provide additional trainings/career building classes to coaches UHA provides services that are tailored to the community and address social determinants of health UHA reduces costs by connecting high utilization beneficiaries into the system via year-long National DPP UHA implements bi-directional referrals for multiple prevention programs via subsidiary screening/referral systems Support subsidiary organizations in completing screening and referrals for health-related social needs (HRSNs) Build referral pathways and bidirectional communication for to social services Gather and analyze data on addressing social determinants of health Provide technical assistance in using program supports Health Equity/SDOH UHO and/or subsidiary organizations have fostered long-term relationships throughout the community UHA is recognized by the CDC through a quality assurance program (i.e., Diabetes Prevention Recognition Program) Maintain consistent engagement with local payers and identify opportunities to define collaborative work Other 9
UHA Value Proposition: Payers Pain Point Value Proposition Specific Actions Administrative Burden Outcomes/Metrics Engagement/Retention Cost Health Equity/SDoH Other 10
UHA Value Proposition Subsidiary Organization Focus 11
Pain Points for Subsidiaries Administration, Operations, and Payer Contracting: Challenges navigating resource intensive processes associated with negotiating and contracting with payers Marketing, Outreach, and Referrals: Lack of resources and funding to outreach or refer participants and meet cohort requirements Data Management: Lack of experience, technology, or acumen to manage data Financial Strategy: Current funding streams available to subsidiary organizations are not sustainable DPRP Recognition Process: Difficulty meeting or maintaining DPRP recognition requirements Billing and Claims: Lack of experience or technology to efficiently submit accurate claims Participant Engagement and Retention: Challenges enrolling and retaining participants in the National DPP lifestyle change program Populations of Focus: Difficulty meeting the access and availability needs of priority populations Policy Priority Landscape: Difficulty navigating changes in policy, particularly during COVID-19 Staffing: Challenges meeting staffing needs and lifestyle coach retention 12
UHA Value Proposition for Subsidiaries Administration, Operations, and Payer Contracting: UHO can support payer education, contract negotiations, and other technical assistance needs Marketing, Outreach, and Referrals: UHAs and partners can support development of subsidiary marketing and outreach efforts and assist in enrollment evaluations Data Management: UHO will provide technical assistance to support subsidiaries with data aggregation, submission, and analysis Financial Strategy: UHAs can connect CBOs to sustainable funding sources through payer reimbursement DPRP Recognition Process: Subsidiaries share UHO recognition status through participation in the UHA Billing and Claims: UHO can submit claims on behalf of subsidiaries through a billing vendor or in-house billing processes Participant Engagement and Retention: UHO will support subsidiaries in retention efforts and tailoring the National DPP lifestyle change program to fit community needs Populations of Focus: UHAs can engage various partners and expand access to reach populations of focus and address health-related social needs Policy Priority Landscape: UHO can assist in navigating current landscapes and increasing capacity for additional evidence-based intervention programs Staffing: UHOs can navigate state specific staffing requirements and support lifestyle coach retention 13
UHA Value Proposition: Subsidiary Organizations - Potential Opportunities Pain Point Value Proposition Specific Actions UHO handles contracting processes for various payers on behalf of subsidiary organizations UHO has relationships with various payers that could be leveraged to execute UHA contracts for reimbursement UHO will negotiate and execute contracts and submit payer claims for subsidiary organizations UHO will have engagement meetings with participating partners to discuss partner needs and strategies to improve access Administration, Operations, and Payer Contracting Subsidiaries can maintain DPRP recognition even with smaller class sizes through the collective size of the UHA UHO will assist subsidiaries in ensuring accurate submission of required DPRP data DPRP Recognition Process UHO contracts with a billing vendor to provide billings and claims services for subsidiary organizations UHO and billing vendor provide trainings, test claims processes, and additional technical assistance (TA) Billing and Claims Through reimbursement and/or payer arrangements, UHO can help to facilitate program supports for the subsidiaries in the UHA UHA provides funding opportunities and state connections to subsidiary organizations to help sustain National DPP programs Participant Engagement and Retention UHO has connections with organizations and individuals who can influence populations and make linkages to other wrap-around services UHO can provide TA to support outreach strategies, including educating providers about the UHA/National DPP UHA works with state health departments to form linkages through which individuals and providers can find resources for self or family members Marketing, Outreach, and Referrals UHO helps subsidiary organizations understand how to reach relevant populations that have engagement challenges UHO partners with organizations who can reach specific populations such as faith-based organizations, as well provide strategies aimed at specific sub-populations Populations of Focus 14
UHA Value Proposition: Subsidiary Organizations Pain Point Value Proposition Specific Actions Administration, Operations, and Payer Contracting DPRP Recognition Process Billing and Claims Participant Engagement and Retention Data Management 15
UHA Value Proposition: Subsidiary Organizations Pain Point Value Proposition Specific Actions Marketing, Outreach, and Referrals Financial Strategy Policy Priority Landscape Cost Populations of Focus Staffing 16
UHA Value Proposition Referral Partner Focus 17
Pain Points for Referral Partners Lack of awareness of program availability Barriers reaching at-risk populations that are not actively seeking care Inability to regularly connect with patients on health-related social needs (HRSNs) Challenges referring patients to programs that are accessible to their lifestyle/circumstances Barriers to learning, understanding, and implementing complex referral platforms Challenges addressing HRSNs in patients (e.g., access to healthy food, maintaining coverage) Challenges referring patients to culturally sensitive/linguistically appropriate programs Difficulty implementing processes to refer patients to prevention programs Patient Engagement Outcomes & Metrics Patient Care Referral Pathways Program Access Health Equity Limited access and reimbursement for evidence-based programs and/or challenges effectively entering a new market Inability to ensure that lifestyle changes are maintained by patients Challenges meeting required health metrics or internal health goals Difficulty performing outreach or ongoing communication with patients outside regular interactions Difficulty capturing data on patient engagement with other providers Difficulty identifying, understanding, & accessing methods to address type 2 diabetes risk within patient population Challenges with patients who delay seeking care for chronic disease Challenges including prevention in patient care 18
UHA Value Proposition for Referral Partners Improve ease of referral to the National DPP (and possibility of bi- directional referrals to receive updates on patient progress) UHA can assist in addressing health-related social needs (HRSNs) by connecting patients to services such as food, nutrition, transportation, primary care services, etc. Partnership with the UHA increases likelihood that National DPP is available in a format, language and location accessible by patients UHO can provide technical assistance to provider as needed on referral database and implementation of referral processes Patient Engagement Outcomes & Metrics Patient Care Referral Pathways Program Access Health Equity Partner can rely on UHA to administer and support their patients through the National DPP lifestyle change program UHA can support referral partners in meeting health metrics or internal goals by improving patient health through participation in the National DPP lifestyle change program UHA can help elevate partner s profile & involvement in the effort to prevent type 2 diabetes and improve health and well-being of patients UHA can assist with outreach to patients who may benefit from participation in the National DPP lifestyle change program UHA can assist in increasing provider access to the National DPP and other evidence-based programs UHA can coordinate with partners to aggregate patient access/referral metrics 19
UHA Value Proposition: Referral Partners - Potential Opportunities Pain Point Value Proposition Specific Actions UHA provides access to CDC-recognized evidence-based programming UHA focuses upstream on prevention of type 2 diabetes and eventually other chronic diseases Partnership with the UHA allows referral partners to focus on acute healthcare needs while prevention is addressed by UHA UHO understands the service landscape, identifies gaps, and engages subsidiary organizations to fill gaps in services UHA offers National DPP and other services to promote lifestyle changes and prevent chronic disease Patient Care UHA trains lifestyle coaches in participant engagement techniques UHAs use program supports to remove barriers to access UHA maintains constant contact with participants from referral to program completion UHA uses the evidence-base to provide ongoing trainings to lifestyle coaches on participant engagement UHA activates creative program supports to remove barriers to engagement UHA assists with patient outreach and identification strategies Patient Engagement UHA supports the achievement of patient health outcomes as cohorts meet weight loss and physical activity metrics UHA reports patient metrics to referral partners Subsidiary organizations support patient communication back to referral partners Outcomes and Metrics UHA supports bi-directional referrals and updates on patient outcomes to referral partners As the number of subsidiary organization grows UHA will activate an expanded network referral partners may access UHA provides technical assistance to support in the implementation and understanding of the referral platform UHO engages a referral platform that allows for bi-directional referrals UHO develops processes to ensure regular communication with referral partners UHO develops evaluation plan to receive feedback from referral partners and perform quality improvement Referral Pathways Program Access UHA ensures National DPP programming is accessible to members/patients of referrals partners In the long run UHA may provide access to additional evidence-based programs UHA provides access to National DPP in multiple modalities, formats, languages, and across a broad network Subsidiary organizations screen and refer for health-related social needs (HRSNs) Subsidiary organizations are embedded in and trusted by communities of focused UHA may activate community health workers and interface with patient navigators as referral partners UHA develops strategies for addressing needs of populations of focus (e.g., language access, transportation, use of telehealth resource) UHA engages with trusted partners in communities and keep them apprised of progress UHO learns about health equity goals of referral partners Health Equity 20
UHA Value Proposition: Referral Partners Pain Point Value Proposition Specific Actions Patient Care Patient Engagement Outcomes and Metrics Referral Pathways Program Access Health Equity 21
UHA Value Proposition Funding/Convening (1705 organizations, State Health Departments, etc.) Partner Focus 22
Pain Points for Funding/Convening Partners Partnerships Population Health Mission Alignment Barriers identifying and addressing the needs of each unique CBO Challenges in navigating industry silos to support collective action Difficulty fully engaging partners with potential to have the greatest impact Difficulty identifying pathways and growing pathways to address multiple health or social needs concurrently Difficulty identifying organizations with a shared vision of improving health within the community Sustainable Funding Health Equity Challenges obtaining/providing sufficient funds to CBOs to ensure organizational/program sustainability Barriers to addressing health-related disparities within the community Challenges meeting health equity goals set by state agencies 23
UHA Value Proposition for Funding/Convening Partners Partnerships Population Health Mission Alignment Partnership with the UHA provides an opportunity to serve as a critical partner to support CBOs in the region with delivery of the National DPP or other administrative needs UHA can improve population health in the community(ies) partners serve by connecting patients to multiple evidence- based lifestyle change strategies through one program A sustainable UHA may advance organization s mission and goals and align with the goals of a UHA UHO will perform outreach to and vet new CBOs for participation in the UHA Sustainable Funding Health Equity By connecting CBOs with sustainable reimbursement, UHAs reduce the need to assist in identifying and/or providing addition funds to CBOs UHAs provide a network of long-term access to patients traditionally underserved by the health care system, which can help improve health equity and help partners meet goals 24
UHA Value Proposition: Funding/Convening Partners - Potential Opportunities Pain Point Value Proposition Specific Actions UHO connects and provides technical/administrative assistance to organizations throughout the community UHA creates a network to share strategies and pilot initiatives across the health landscape UHO serves as a liaison to state agencies on behalf of subsidiary organizations Leverage existing meetings to continue relationship building with partners (including meetings that do not relate to prevention of type 2 diabetes) UHO learns and crosswalks relevant priorities from convening and funding partners and outlines how UHA can address those priorities Partnership UHA serves as a one-stop-shop to the identified participant population and provide resources to make sustainable lifestyle changes to prevent chronic disease and improve population health UHO works to understand governor, state (public) health department, state Medicaid agency, health system, and other priorities related to population health and chronic disease prevention Population Health UHOs enlist a variety of organizations to participate in the UHA all of whom share a vision of improved health outcomes and reduction of health disparities UHO ensures UHA documents (e.g., charters) are aligned with goals and priorities of convening partners Mission Alignment UHO connects CBOs with sustainable funding sources through claims reimbursement, reducing the need to connect CBOs to additional funding sources UHO develops financial strategy to transition over time from grant funding to payer reimbursement, eventually freeing up resources for other priorities. Sustainable Funding UHA addresses health equity by reducing the administrative burden of CBOs, allowing them to focus on delivering the National DPP and addressing unique patient needs Subsidiary organizations screen and identify pathways to connect patients with SDOH supports (transportation, nutrition, housing, etc.) improving the overall health of the community Health Equity 25
UHA Value Proposition: Funding/Convening Partners Pain Point Value Proposition Specific Actions Partnership Population Health Mission Alignment Sustainable Funding Health Equity 26
Creating a Unique Value Proposition: Next Steps 27
Next Steps After you have completed the value proposition workshop consider one or more of the next steps: Create a written document to summarize the value proposition for internal leadership Use the results from the workshop to engage with partners (see slide 28 for additional communication resources) and validate the fit of the value proposition For best results, plan to revisit and update the value proposition as necessary during operationalization of the UHA Integrate the relevant action steps from the value proposition workshop into the UHA workplan Examine each value proposition and check for feasibility for your UHA Create a financial analysis of the cost/benefit to the UHA for providing each value proposition 28
UHA Resources The below resources, available on the Coverage Toolkit UHA page, can assist in developing your unique value proposition. Checklist to Help Organizations Establish a UHA UHA Modifiable Slide Deck Landscape Analysis for UHAs UHO Capacity Assessment UHA Questionnaire for CDC-Recognized Organizations Learnings from the Umbrella Hub Demonstrations (Functions of a UHO pages 10-14) 29
The Building the Delivery Infrastructure for the National DPP Through Strategic Partner Convenings project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $900,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. The National Association of Chronic Disease Directors - Promoting Health. Preventing Disease. The National Association of Chronic Disease Directors (NACDD) and its more than 7,000 Members seek to strengthen state-based leadership and expertise for chronic disease prevention and control in states and nationally. Established in1988, in partnership with the U.S. Centers for Disease Control and Prevention, NACDD is the only membership association of its kind to serve and represent every chronic disease division in all states and U.S. territories. For more information, visit chronicdisease.org. If you require this document in an alternative format, such as large print or a colored background, please contact the Communications Department at publications@chronicdisease.org. Alternate formats can be made available within two weeks of a request. 30
