Five Concepts Driving the Colorado Business Group on Health

With Donna Marshall’s recent retirement after 20 years, it seems appropriate to articulate, reflect on, and perhaps reaffirm, the key concepts that motivate us at CBGH.  While healthcare and the economics that shape its delivery can be complex and difficult to understand, the following concepts are really quite simple – and central to our efforts.


  1. Healthcare cost containment must begin with quality improvement. Business coalitions began in response to rising healthcare costs.  But sophisticated leaders, like Donna, understood that unjustifiably wide variations in resource use and outcomes were and remain the primary drivers of healthcare costs.   This foundational precept was reinforced by the 1999 Institute of Medicine report, To Err is Human: Building a Better Health System. The report described extreme levels of “quality waste” resulting from of a “healthcare system at odds with itself.”  While some targeted the results of a wasteful system, like high prices, CBGH decided to promote tools and practices for addressing the causes, such as variation in outcomes.  This basic concept still serves as our focal point.


  1. Quality improvement is a team sport – particularly for purchasers. Just as we know that clinical teamwork is key to improved quality, we also see the need for employers to work collaboratively around quality.  With each health system and health plan merger, the individual employer’s voice is diminished.  Only employers – as purchasers, have the incentive to address the root quality problems.  Instead of shifting risks and costs to employees, employers can force plans and providers to offer a higher value proposition.  To do so, they must work together.


  1. Health plans are intermediaries, not purchasers. This statement of fact neither criticizes nor denigrates the role that health plans play.  Their core functions are essential in our system.  But health plans process claims, they are NOT payers.  Funding for healthcare does not originate with them.  It originates with employers: private employers who must increase prices or cut costs to pay for exorbitant increases and public employers who then must restrict either services or wage increases.


  1. Healthcare is a foundational economic development issue. Because employers and their employees bear the inflationary costs of an inefficient system, CBGH considers healthcare to be a basic economic development issue.  In compromising the profits and salaries of our domestic companies and the competitiveness of our international companies, and in limiting the discretionary spending of our workers, healthcare hampers our economy.  Healthcare waste robs monies from our schools, our roads, our public services and our retirements.


  1. We deserve better. Medical errors are now the third leading cause of death in the US.   While you CAN get the world’s best care in the US, the problem is you DON’T ALWAYS.  Yet we spend two, three, and four times what other countries spend on healthcare.   This should not be okay.  Our families and our employees deserve better.  In the end, it really comes down to that.


The opportunity to continue the work of the CBGH – on behalf of our members and their employees – is an honor for all of us at CBGH.  While evolving markets and circumstances may change our strategies and tactics, our purpose remains constant: to support employers and work with providers in assuring that enrollees receive the right care at the right time at the right cost.


Bob Smith
Executive Director/ CBGH