Your Partner in Health
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Health plans should act as a beneficial and reliable source of information needed for making health care decisions. However, improvements can only be made after quality is measured. For example, since Rocky Mountain Health Plan (RMHP) began publicly reporting their CAHPS reports to CBGH in 2010, their four lower than average scores that CBGH reports have improved to only leave one score below average. In fact, when RMHP initially began reporting none of their scores were above average, but in 2012 three are! Cigna and Kaiser Permanente continue to lead Colorado health plans in member satisfaction of the health plan as a whole. HMO Colorado (Anthem BCBS) continues to be rated consistently with their average scores across the board. This purchasing guide is intended to assist private purchasers of health care coverage to switch from the traditional health care purchasing model of paying based on volume to the rapidly emerging model of paying based on value. Paying based on value is a proven technique of improving quality and lowering costs. It emphasizes purchasing strategies that:
a) use alternative payment models that motivate and reward quality and efficiency; and,
b) support delivery system reform.
This guide describes the need for payment and delivery system reform, highlights the most promising reform ideas and then describes some steps health care purchasers can take to switch to purchasing on value.
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Welcome to the latest issue of Purchasing High Performance, a newsletter designed for employers and coalitions seeking value in health care, sponsored by the National Business Coalition on Health and The Commonwealth Fund. Perspectives on Policy The Supreme Court has weighed in, upholding the landmark health care reform law. That clears the way for the state and federal health exchanges to start revamping the way many Americans and American employers buy health care. What will this and other coming changes mean for employers? [Read more] Case Study As CareFirst Tweaks the Medical Home, Doctors Flock and Costs Dip The results are in following the first year of one of the nation's largest medical home efforts and they're all good. Powered by a novel approach to providing small physician practices with access to necessary information technology, CareFirst's medical home effort boasts broad participation and a decline in net spending versus projections. Will employers take note? [Read more] Featured Articles "Choosing Wisely" Campaign Takes Aim at Overuse Nine leading medical societies recently launched an effort to curb 45 different medical procedures that are done way too often. How can you help? [Read more] Smart Phones and Social Media vs. Bad Peanut Butter Technology is changing how, where, and when we see the doctor, learn about our various maladies, and fight back against disease. Will it also save money and make us healthier? [Read more] Today's CFOs are asking benefits managers to help quantify the value of company investments in health care and wellness. Here's how to answer. [Read more] Is There a Place in the Market for Private Exchanges? Insurers, consultants, and employers of all sizes are thinking about setting up their own private health exchanges that would operate alongside their public counterparts. What's the appeal and will they take off? [Read more] |