Making our Mission and Vision a Reality
At the Alliance’s Board of Directors retreat last week, we talked a lot about how we define and measure the impact of the Alliance’s work. We know very well that you can’t improve what you don’t measure and we are not immune from the magnifying glass we use to evaluate the health care system. The only way we can know if we are accomplishing our mission and vision is to track our progress.
Our mission, “to build and maintain a strong alliance among purchasers, providers, health plans, and consumers to promote health and improve the quality and affordability of the health care system in Washington state,” is a good one. I would say that with our 185+ members, we have built and maintain a strong collaborative group that is deeply committed to improving the quality and affordability of health care in our state. With our waste, quality, and pricing research, we are taking important steps to understand the issues that keep us from the high quality and low cost health care we hope to accomplish.
Where we need to direct our efforts now is in reaching our vision, to “achieve top 10% performance in the nation in the delivery of equitable, high quality, evidence based-care and in the reduction of unwarranted variation, resulting in a significant reduction in the rate of medical cost trend.” Back in the early days we thought we’d be able to check that off the list by 2017. No, seriously, we did. We all had a good chuckle when we recently discovered some old folders tucked away in storage with that date boldly emblazoned on our vision. The last Community Checkup makes clear that, as a state, we are not even close to that goal. On all NCQA measures but one (eye exams for people with diabetes), Washington is not in the top 10%. In fact, for more than half of the measures, we are below the national 50th percentile. We have a long way to go to make that vision a reality. But I believe we have the tools and broad stakeholder commitment to make it happen.
First, we continue to lead the way in using data to promote transparency and drive improvements in the health care system. Second, we know that our work has been used to make important changes that have had profound results. Some employers report they have selected health plans and benefits based on our analysis. With those changes, their members are receiving care that not only beats the state average, it exceeds national benchmarks. Health plan members tell us that they regularly use our reports in physician and hospital contracting and providers tell us that our reports are invaluable in their internal quality improvement efforts and as they gauge their performance against the market.
We all know that cost is a critical issue. According to the National Conference of State Legislatures, the average annual premium for employer-based family health insurance was nearly $20,000 in 2018, with employees covering the cost of nearly 30% for family coverage and 20% of the cost of single coverage. We also know that some Alliance purchasers are making incredible strides in this area. One utilized Alliance results in its plan selection choices that made it possible to not only provide higher quality health care but resulted in a savings of $7,000 a year per member. Another used the guidance we issued with the Bree Collaborative to change how it covered opioid prescriptions, resulting in better care and a savings of more than $4 million in one year.
But most importantly, we know that these are not the only success stories out there. We believe that we can reach our vision of being in the top 10% of performance in the nation by building on successes that are already happening and leveraging our collective efforts. But, we can only do that if we know about them.
Please share your success stories with us so that we can help others achieve the same results. We’ll highlight your work in upcoming newsletters and other public forums to give you and your organization visibility and acknowledgment for your great strides.
As always, I appreciate your support of this work and look forward to hearing from you.
All the best,
Nancy Giunto