Why Join a Health Care Coalition?

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Dwayne Golden
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1 Why Join a Health Care Coalition? Jerry Custer, Executive Director Heartland Healthcare Coalition a member of the National Business Coalition on Health [XYZ Coalition logo]

2 Presentation Outline Setting the Table: What Employers Want Help is on the Way! About the Heartland Healthcare Coalition What we do? What s in it for me? Advancing the Value Based Purchasing Agenda 2

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

4 But Employers are Bewildered 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 4

competitive disadvantage Best of Times: Industry leaders know that

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 as opposed to care delivered inefficiently, in unsafe environments and at the wrong time 5

Better, safer, more appropriate health care as opposed to care

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 6

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 7

political cover to move the market toward the health care system they want to buy

8 About the Heartland Healthcare Coalition 8 Founded in 1990 We have 42 members, representing 365,000 covered lives Manufacturing & Service Industries, City & County Governments, Education, Healthcare, and Insurance/Financial organizations. Our mission is to commit to working together to promote quality and cost-effectiveness in the allocation, management, and use of health care resources available in its member s communities.

9 Coalition Member Value Quality Improvement Initiatives Group Purchasing Programs Educational/sharing Opportunities Opportunity to play an important role in shaping the healthcare system in our community for the future. 9

Opportunities Opportunity to play an important role in

10 What We Do? Our Services Heartland Healthcare Coalition offers the following services: Examples include: group purchasing for PBM Services, Dental Plans, Vision Plans, and Physical Therapy Services; quality improvement initiatives; and community partnerships. 10

11 What We Do? Our Goals Heartland Healthcare Coalition is committed to: Fostering communications and action among business leaders on health care issues Working with the local provider community Value-based purchasing of health care services Providing its members with educational opportunities that enhance their ability to become more knowledgeable in cutting-edge health care initiatives. 11

among business leaders on health care issues Working with the local provider community

12 What s in it For Me? Benefits of Coalition Membership Strength in numbers - leverage the market for numerous health care services at group purchasing rates. Pool expertise with experienced peers Attend Annual Health Care Conference at reduced rates. Receive HHC survey data on medical plan designs, costs, Rx plan designs, etc. Share information & best practices - learn from your peers Make a difference in the lives of your employees and in the community 12

13 National Business Coalition on Health We are 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 13

members 25 million covered lives NBCH s mission is to provide superior membership service &

14 14 NBCH Member Coalitions

15 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 15

Annual Conference, CEO/Corporate Leadership Roundtable, and National Health Leadership Council meetings Access to the

16 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 16

patient outcomes, and dollar outlays toward health help manage the system in its reduction of inappropriate care and reward for

17 Advancing the Value Based Purchasing Agenda: Measure, Report, Reward, Inform, & Lead NBCH s Five Pillars: 1. Performance Measurement 2. Transparency and Public Reporting 3. Payment Reform 4. Informed Consumer Choice 5. Purchaser Leadership and Action 17 Accelerating the pace to the ultimate goal: health and health care improvement

Transparency and Public Reporting 3. Payment Reform 4. Informed Consumer Choice 5.

18 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 18

employer leadership engagement, there will be no reform National and

19 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 19

community by community The biggest obstacle to progress is not absence of value based purchasing strategies

20 Contact Us For more information about Heartland Healthcare Coalition or if you re interested in membership, please contact Jerry Custer at or or Holly Geier at or Visit us on the web at 20

Jerry Custer at 309-266-8812 or hhc@mtco.

MEDICAID MANAGED CARE PROGRAM MANAGEMENT: THE NEXT GENERATION ANNE JACOBS, MANAGING DIRECTOR NAVIGANT HEALTHCARE

MEDICAID MANAGED CARE PROGRAM MANAGEMENT: THE NEXT GENERATION ANNE JACOBS, MANAGING DIRECTOR NAVIGANT HEALTHCARE Page 1 WHAT S EXPECTED OF MEDICAID HEALTH PLANS? Some might ask, if the delivery system