Leveraging the collective power of purchasers to transform health care

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Leveraging the collective power of purchasers to transform health care

Value-based purchasing is industry speak for something we do every day—buy things, services and experiences. In each purchase we weigh cost and quality to determine value.

We can purchase health care services in the same way if we ask the right questions, collaborate with brokers, health plans and providers and push for answers. This takes tenacity, and purchasers have to engage fully and drive this process. In fact, without a strong purchaser-driven countervailing force, value-based payment reform often reverts to a “least common denominator,” low-risk model that does little to challenge the current status quo.

Luckily, the Alliance has resources that can help you identify and address real world health benefits issues as you approach open enrollment and consider integrating value metrics into your purchasing decisions. For example:

  • The average age of my employee group is 53 years old and a large proportion of my staff are challenged by chronic conditions like diabetes and heart disease. Is there a resource that gives me insight into the quality of medical groups providing care for these diseases? Consult the Community Checkup website to see how well different medical groups and clinics deliver high-quality care for these diseases.
  • My company is rapidly growing and many new employees are from out of town and are looking for a physician. I’m looking for something beyond just a list of medical groups that are located close to home or office. Can the Alliance help? Yes, consult the Alliance report called Your Voice Matters: Patient Experience with Primary Care Providers.
  • My company is looking for a new health insurance carrier. I know the cost, but how do plans compare on things like health promotion, member and provider support, disease and drug management and patient safety. Is there a report that gives me this insight? Yes, read the Report on Health Plan Performance: eValue8™.
  • My employee is talking to her doctor in Olympia about a procedure called a spinal fusion. She’s deciding whether to get a second opinion, and whether there are options for her care. Additionally, her mother lives in Seattle and she wonders if she should have surgery there and recover with her Mom’s support. What do I advise her to do?  Refer your employee to the report called, Different Regions, Different Health Care: Where You Live Matters.

The Alliance is pleased to be working closely with the Washington State Health Care Authority to promote value-based purchasing for public and private employers. Keep an eye out for our “Savvy Shopper” series, aimed at helping consumers become better educated about the value of their care.

Today, the health care system is designed to pay for volume. Doctors and hospitals are rewarded for quantity (more visits, tests and procedures), not quality, even though unnecessary care adds costs and potential harm for patients. Luckily, the industry is changing to one that rewards value, which considers both the quality and outcomes of care as well as the costs. How health care purchasers buy health care can change the way care is delivered—for the better. If you are a purchaser, please call if you’d like information to inform your benefit strategies or if you have any questions about how value-based purchasing works. We would be pleased to help.

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