Driving Improvement Together
The Washington Health Alliance (Alliance) recently completed a purchaser-led project with the central aim of using data and collaboration to fuel collective action. In its white paper, Aligning to Drive Value: Using Data, Relying on Evidence, and Building on Trust, the Alliance shares the learnings gained through its work with eight self-funded purchaser members, which includes private and public employers, union trusts, and a multi-employer plan. Together, they provide health benefits to approximately 550,000 individuals or about 7% of Washington state’s population.
Each purchaser received customized reports that identified high- and low-value improvement opportunities. These reports included 48 measures of low-value care using the Milliman MedInsight Health Waste Calculator™ that serves as the basis of the First, Do No Harm reports published by the Alliance and 24 measures of high-value care from the Community Checkup, a comprehensive report on health care quality that has been published by the Alliance since 2008.
Alliance purchasers selected improving the value of care for low-back pain as a shared priority for action. Informed by collaborative discussions with provider and health plan leaders, purchasers developed patient and provider-focused strategies to improve the care of low-back pain consistent with the strong evidence-base for non-opioid, non-invasive services.
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The Driving Value Project was supported by Arnold Ventures, a philanthropy dedicated to investing in evidence-based solutions that maximize opportunity and minimize injustice.
Alliance Moves Forward on Driving Value Together Project
Alliance Director of Performance Improvement and Innovation Karen Johnson shared our progress on the Driving Value Project with the Smarter Health Care Coalition (Coalition), committed to working together to improving health care in a variety of ways with a strong focus on policy. The Driving Value Project supported by Arnold Ventures, is working with eight self-funded members of the Alliance to identify and reduce low-value care and increase high-value care.
The Coalition’s goal is to integrate benefit design innovations and patient engagement to achieve smarter health care that improves the patient experience. In particular, the Coalition is focused on better aligning health insurance coverage, quality, and value-based payment goals. Created in 2016, building on the work of Dr. A Mark Fendrick, Director of the University of Michigan Center for Value-Based Insurance Design, and Harvard Medical School Professor Michael Chernew, the Coalition represents a broad-based and diverse group of health care innovators, including consumer groups, employers, patient advocacy organizations, health plans, and life science companies.
The Coalition recently issued a letter asking US Department of Health and Human Services Secretary Xavier Becerra to:
- eliminate Medicare payment for services rated “D” by the U.S. Preventive Services Task Force;
- allow Medicare Advantage organizations to reduce payments or increase cost-sharing for “D” rated, harmful preventive services; and
- enable the Center for Medicaid and Medicare Innovation to build a new, multi-state demonstration project to reduce low-value care in commercial, Medicare, and Medicaid populations.
The Alliance leveraged the First, Do No Harm report series on low-value care, as well as the ongoing work we do to report on high-value care in the Community Checkup, to create the Driving Value initiative, made possible with $350,000 in support from Arnold Ventures.
This support enables us to work with a group of self-insured purchaser members of the Alliance, representing more than 550,000 members across the state, to improve the value of care received by their plan participants. The Driving Value project provides purchaser members the opportunity to benefit individually within their own organizations, as well as to have a collective impact by working collaboratively with each other as well as with providers and health plan leaders across the state to propel action. The participants are currently in the process of exploring how they can collectively improve the value of care for those suffering with low-back pain by increasing reliance on evidence-based, non-opioid, and nonsurgical treatments.
We are “the tip of the spear” in this kind of purchaser-led multi-stakeholder collaboration, according to our external advisor to the project, Dr. A. Mark Fendrick, who leads the Center for Value-Based Insurance Design at the University of Michigan. This effort is already attracting national attention with this innovative approach. Stay tuned for updates on our progress and learnings from this endeavor.