A Business Strategy: Health Care Coalition

1. A Business Strategy: Health Care Coalition Marilyn Bell Michigan Purchasers Health Alliance a member of the National Business Coalition on Health September 23, 2010

2. Presentation Outline • Setting the Table: What Employers Want • Help is on the Way! • About the Michigan Purchasers Health Coalition (MichPHA) • What we do? • What’s in it for me? • Advancing the Value Based Purchasing Agenda

3. Setting the Table:What Do Employers Want? Three Things: • Lower health care costs • Improved workforce health and productivity • Improved health care VALUE

4. 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

5. Something Employers Can Relate to • The business world appreciates efficient services costing less • 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

6. What are the Impediments? • 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

7. Help is on the Way! • 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

8. 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 • 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.

9. MichPHA Members Allegiance Health Great Lakes Employee Benefit Services Alpha Technologies Malloy Incorporated Alro Steel McGraw Wentworth Consumers Energy Merck & Co., Inc Dawn Food Products, Inc Moretz Technologies Great Lakes Industries Sensors, Inc. Jackson County Chamber of Commerce The Kennedy Group Jackson District Library Visteon Gerdaumacsteel

10. Coalition Member Value • Quality Initiatives • Group Purchasing Programs • Educational/sharing Opportunities • Catalyst for Change • Consumer Resources • Access to National Programs/Resources • Updates on Health Care Reform

11. What We Do?Our Services • MichPHA offers the following services: • 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

12. What We Do?Our Goals • MichPHA is committed: • 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

13. CURRENT PROJECTS AHRQ Small Conference Grant • 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

14. 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

15. What’s in it For Me? Benefits of Coalition Membership • 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

16. 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 • 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

17. NBCH Member Coalitions

18. 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: • 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)

19. Value Based Purchasing (VBP) in a Nutshell • An Explanation from the Agency for Healthcare Research and Quality (AHRQ) • 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

20. Value-Based Insurance Design (V-BID) • 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

21. Value Based Benefit Design (VBBD) • 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.

22. NBCH’s Five Pillars and adopted by MichPHA: Performance Measurement Transparency and Public Reporting Payment Reform Informed Consumer Choice Purchaser Leadership and Action Accelerating the pace to the ultimate goal: health and health care improvement Advancing the Value Based Purchasing Agenda: Measure, Report, Reward, Inform, & Lead

23. Great Battle Plan… but Where are the Employer Generals? • 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

24. 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

25. 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 for-profit, non-profit or municipality.” --Jim Delaney, Human Resource Administrator, Jackson District Library

26. Contact Us • For more information about Michigan Purchasers Health Alliance or if you’re interested in membership, please contact Marilyn Bell (269-668-4149, mhbell@michpha.org) • Visit us on the web at www.michpha.org • Join us September 23, 2010 Annual Conference “Local Healthcare Reform: Cost Containment Opportunities for Employers”