Transcript Marilyn Bell - Michigan Purchasers Health Alliance

A Business Strategy:
Health Care Coalition
Marilyn Bell
Michigan Purchasers Health Alliance
a member of the
National Business
Coalition on Health
September 23, 2010
Presentation Outline


Setting the Table: What Employers Want
Help is on the Way!
–
–
–

2
About the Michigan Purchasers Health Coalition
(MichPHA)
What we do?
What’s in it for me?
Advancing the Value Based Purchasing Agenda
Setting the Table:
What Do Employers Want?
Three Things:

Lower health care costs

Improved workforce health and productivity

Improved health care
VALUE
3
But Employers are Frustrated
A Tale of Two Cities:
 Worst of Times: Rising disease burden and health
care costs put American industry at a competitive
disadvantage
 Best of Times: Industry leaders know that
reengineering, technology, and a consumer focus
can drive improved quality and lower costs
4
Something Employers Can Relate to

The business world appreciates efficient services
costing less
–

5
Health care is no different
Better, safer, more appropriate health care costs
as opposed to care delivered inefficiently, in
unsafe environments and at the wrong time
What are the Impediments?




6
Not our business – “We make widgets”
Health care dynamics are hard to master
Corporate silos
Difficult to look beyond individual employer
strategy to collective engagement
Help is on the Way!



7
Coalitions of employers, acting together, have the
purchasing leverage and political “cover” to move
the market toward the health care system they
want to buy
Transformation requires access to resources—
resources that we can provide
Employers have an imperative role to play in the
shift to value based purchasing
Michigan Purchasers Health Alliance


Founded in 1995
We have 18 members, representing 25,000 covered lives
- large utility, auto supplier, steel companies, printers, technology,
manufacturing, health system, pharma, library

8
Our mission is to enact plans and programs that ensure
an affordable, high quality, cost-effective health care
system for employees of MICHPHA members and to
provide a forum for continuous improvement of that
system.
MichPHA Members
Allegiance Health
Alpha Technologies
Alro Steel
Consumers Energy
Dawn Food Products, Inc
Great Lakes Industries
Jackson County Chamber of Commerce
Jackson District Library
Gerdaumacsteel
9
Great Lakes Employee Benefit Services
Malloy Incorporated
McGraw Wentworth
Merck & Co., Inc
Moretz Technologies
Sensors, Inc.
The Kennedy Group
Visteon
Coalition Member Value







10
Quality Initiatives
Group Purchasing Programs
Educational/sharing Opportunities
Catalyst for Change
Consumer Resources
Access to National Programs/Resources
Updates on Health Care Reform
What We Do?
Our Services

MichPHA offers the following services:
–
–
–
–
–
11
Group purchasing—PBM, Dental, Flu Vaccine, PPO Network
Quality initiatives—Reports from health systems on outcomes &
process
Educational Programming—Annual Conference, quarterly
meetings, webinars
Community Partnerships— Collaboration with JCHD and
Allegiance Health
Public Reporting—Annual report with local hospital data, reform
updates, value-based benefit design
What We Do?
Our Goals

MichPHA is committed:
–
–
–
–
–
–
–
12
To promote effective and efficient use of health resources.
To provide the education and tools so that member employers and their
employees are more knowledgeable purchasers of health care.
To establish and maintain a regular dialogue between area providers of
health care and employer purchasers of health care.
To work with providers to assure appropriate use of medical care
resources.
To preserve and improve competition that enhances quality assurance,
cost effectiveness, and access.
To minimize increases in the cost of providing quality health services.
To promote & support population health
CURRENT PROJECTS
AHRQ Small Conference Grant
–
–
–
–
–
13
One day workshop 3-25-11
Small to mid-sized employers
Value-based purchasing
Experts in small ER issues & limitations, Economy,
Research, Value-based Insurance Design
Set foundation for research of this size group
CURRENT PROJECTS (cont)
Community Partnerships— Population seed grant to
develop employer toolkits for tobacco cessation,
nutrition, physical activity, & emotional health in
Jackson County
MedEncentive— Incentives for Physician to follow EBG
and incentives for Employees to improve medical
literacy & commit to plan of care (Mutual
Accountability), Partnership with MAFP
14
What’s in it For Me?
Benefits of Coalition Membership







15
Strength in numbers - leverage the market
Pool purchasing power for savings and quality
Stay on top of new developments and issues
Advocate on areas of common interest
Share information & best practices - learn from your peers
Collaborate with members of the health care system
Make a difference in the lives of your employees and in the
community
National Business Coalition on Health

MichPHA is a member of the National Business
Coalition on Health (NBCH), which represents
nearly 60 coalitions across the country
–
–

16
7,000 employer members
25 million covered lives
NBCH’s mission is to provide superior
membership service & to build the capacity of its
membership to advance value based purchasing
of health care services
NBCH Member Coalitions
17
Benefits of NBCH Membership

Members have access to NBCH’s network of coalitions
and can benefit from networking, lessons-learned, best
practices, tools and programs including:
–
–
–
–
–
–
–
18
All-member calls and webinars
Participation in NBCH’s Annual Conference, CEO/Corporate
Leadership Roundtable, and National Health Leadership Council
meetings
Access to the NBCH Members Only website
Access to the eValue8 RFI
Access to all NBCH publications
Access to government affairs and legislative updates
Access to research reports from Integrated Benefits Institute (IBI)
Value Based Purchasing (VBP) in a Nutshell

An Explanation from the Agency for Healthcare Research
and Quality (AHRQ)
–
–

19
Health care purchasers should hold health care providers
accountable for both cost and quality
Information collected on quality of care, patient outcomes, and
dollar outlays toward health help manage the system in its
reduction of inappropriate care and reward for high-performing
providers
Limited number of employers acting in bold ways but a
moderate amount are taking necessary first steps
Value-Based Insurance Design (V-BID)



20
Value equals the clinical benefit achieved for the
money spent
Health care services differ in the health benefits
they produce
The value of health care depends on the
individual who receives the service
Value Based Benefit Design (VBBD)



21
Appropriate use of high value services, including
certain prescription drugs and preventive
services;
Adoption of healthy lifestyles, such as smoking
cessation or increased physical activity,
Use of high performance providers who adhere
to evidence-based treatment guidelines.
Advancing the Value Based Purchasing
Agenda: Measure, Report, Reward, Inform, & Lead
NBCH’s Five Pillars and adopted by MichPHA:
1.
Performance Measurement
2.
Transparency and Public Reporting
3.
Payment Reform
4.
Informed Consumer Choice
5.
Purchaser Leadership and Action
Accelerating the pace to the ultimate goal:
health and health care improvement
22
Great Battle Plan… but Where are the
Employer Generals?





23
The unanswered question
“Culture beats strategy every time”
Without top employer leadership engagement,
there will be no reform
National and community leadership required
Join a coalition for additional support, guidance,
and resources
Key Take Aways




There’s gold at the end of the rainbow of improving
health care quality and efficiency
Business and health coalitions are the key to the vision of
health care reform, through value based purchasing,
community by community
The biggest obstacle to progress is not absence of value
based purchasing strategies but absence of employer
engagement and leadership
There’s a reason we’re here: we’re the only
motivated change agents
24
Member Comments




“We all need to be part of the solution in partnering with our
medical communities to promote healthy behaviors and improve
risk-factors.”
“The group-purchased products are a great opportunity that, in
some cases, have multiple layers of savings.”
“There’s a lot that can be done, even today, to mitigate benefit plan
cost escalation – but you have to know your options.”
“The education meetings alone will keep you well ahead of most of
your colleagues and add-value to your organization, whether forprofit, non-profit or municipality.”
--Jim Delaney, Human Resource Administrator,
Jackson District Library
25
Contact Us
For more information about Michigan Purchasers
Health Alliance or if you’re interested in
membership, please contact Marilyn Bell (269668-4149, [email protected])
 Visit us on the web at www.michpha.org
 Join us September 23, 2010 Annual Conference
“Local Healthcare Reform: Cost Containment
Opportunities for Employers”

26