Alliance Blog

Using Data to Drive Value

August 31, 2020 by Washington Health Alliance

You often hear me talk about driving our work to action and I’m delighted to share some exciting news on a project that will do just that. The Alliance has been awarded a $350,000 grant by Arnold Ventures to work with self-funded purchasers to improve the value of care delivered across Washington state. Arnold Ventures, a philanthropy dedicated to improving lives by investing in evidence-based solutions is focused on four areas, criminal justice, education, finance, and health. It has funded more than a thousand projects since 2010, supporting “efforts to understand problems and identify policy solutions.”

This grant will enable the Alliance to assess the value of the care received by enrollees of up to eight employers and provide targeted technical assistance to help each employer implement effective strategies to reduce low-value care and increase high-value care. The work will occur in two phases. First, we will use the Milliman MedInsight™ Health Waste Calculator to analyze claims data for each purchaser to get results that are specific to its covered population. Then, we will bring together purchasers, commercial payers, and clinical leaders to develop strategies and provide technical assistance necessary to help ensure patient and clinician incentives are aligned to support the delivery of high-value care. Interventions will be designed with the specific purchaser’s needs in mind, but we expect it will be a combination of benefit coverage and design, shared decision-making, and consumer education. The results of the case study will be published in a white paper summarizing key findings which can potentially be used by policy practitioners and healthcare experts to improve the value of care delivered and increase the efficiency of healthcare delivery across the country.

Our Director of Performance Improvement and Innovation, Karen Johnson, will be leading the effort and we are fortunate to have expert advice from Dr. A. Mark Fendrick, who conceptualized and coined the term Value-Based Insurance Design (V-BID) and currently directs the V-BID Center at the University of Michigan. Most recently, Fendrick built on the decades long work in VBID and introduced VBID-X, a cost-neutral approach that encourages the reallocation of savings derived from reductions in low-value care to support an increase in the use of high-value services. In “V-BID X: Creating A Value-Based Insurance Design Plan for The Exchange Market”, Fendrick and his colleagues described this concept stating that “By abandoning blunt cost-sharing strategies and using a more clinically nuanced approach, V-BID X plans incentivize consumers to use more of the services that improve their health and less of those that don’t.”

In our latest First, Do No Harm Report, we said that “transparency is foundational for taking action – shining a light on low-value care, unwarranted variation, and the opportunities it presents. But taking action is paramount.” I’m proud that we will have the opportunity to take action with purchaser members who are dedicated to reducing low-value care and to strategize with provider and health plan members on ways we make these changes happen together.

I look forward to reporting on our progress at driving greater health care value.

All the best,

Nancy