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What Do Employers and Other Health Care Purchasers Really Want?

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Employers and other health care purchasers and Americas leading medical groups are collaborating to find solutions to fix the fragmented U.S. health care delivery system.

A new report, Exploring Employer-Physician Collaborations to Deliver Quality Care, presents the results of the first initiative, a series of listening sessions coordinated by the Council of Accountable Physician Practices (CAPP), a coalition of the nations leading medical groups and health systems, and the National Alliance of Healthcare Purchaser Coalitions, a nonprofit purchaser-led organization representing more than 45 million Americans. The listening sessions took place with National Alliance coalition members in Illinois, Texas, Washington, North Carolina and Pennsylvania.

Both purchasers and providers want patients to receive high quality health care, said Norman Chenven, M.D., vice-chairman of CAPP, founding CEO of Austin Regional Clinic and President and CEO of Covenant Management Systems. Together, we can collaborate on broad-based initiatives to close those gaps and provide better, more affordable health care.

Michael Thompson, president and CEO of the National Alliance, commented, Health care purchasers and providers have similar goals, but we have not often engaged in direct dialogue. These listening sessions provided a forum for discussion and problem solving. Purchasers will benefit from new information and ideas that can improve their employees care and provide results for the investment made in that care.

The report details barriers employers face in offering high quality and affordable care to employees, including:

  • Lack of care coordination. Self-insured employers want their employees to experience seamless care, and to receive additional support navigating the medical system when they have a health problem or serious illness.
  • Access to care, especially specialists and mental health care. Employers recognize the importance of mental health and its link to productivity. They want employees to have timely access to needed specialized services.
  • Delays in care due to access issues. Barriers to access include provider shortages, especially in rural areas, and high costs for care.
  • Inability for employers/purchasers to assess provider quality. This is due to lack of transparency in sharing quality metrics, and lack of data that addresses their individual challenges.
  • A problematic fee-for-service payment system that has been slow to adopt value-based payment models, despite the understanding of how the predominant fee-for-service payment system affects cost, quality, and patient experience.

Many of the issues presented in the report have been exacerbated by the COVID-19 pandemic. The challenges with the current system in responding to this public health crisis have had detrimental effects on patient care and highlighted the financial vulnerabilities of fee-for-service providers. As the increasing use of telehealth to improve access has illustrated, there are opportunities for health system transformation when stakeholderslike purchasers and providersshare a common goal.

The pandemic also revealed how CAPPs integrated medical groups and health systems have already incorporated features of care delivery that address employers concerns, such as care coordination for patients with chronic or serious conditions, investments in telehealth that enabled them to rapidly scale remote visits and overcome access issues, and innovations for value-based care delivery.

The next steps in the ongoing dialogue will be virtual round tables held with National Alliance coalitions and CAPP physician leaders to further define such goals and craft possible solutions.

About the Council of Accountable Physician Practices

The Council of Accountable Physician Practices (CAPP), an affiliate of the AMGA Foundation, is a coalition of visionary medical group and health system leaders. We believe that physicians working together, backed by integrated services, systems and data and technology, can best shape and guide the way care is delivered so that the welfare of the patient is always the primary focus. www.accountablecaredoctors.org

About the National Alliance of Healthcare Purchaser Coalitions

The National Alliance of Healthcare Purchaser Coalitions (National Alliance) is the only nonprofit, purchaser-led organization with a national and regional structure dedicated to driving health and healthcare value across the country. Its members represent private and public sector, nonprofit, and Taft-Hartley organizations, and more than 45 million Americans, spending $300 billion annually on healthcare.

www.nationalalliancehealth.org

Joy Scott, CEO, Scott Public Relations

[email protected]

Phone: (818) 610-0270