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

4. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 17 NBCH Member Coalitions

18. 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. 19 Value Based Purchasing (VBP) in a Nutshell An Explanation from the Agency for Healthcare Research and Quality (AHRQ)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. 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. 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. 22 Advancing the Value Based Purchasing Agenda: Measure, Report, Reward, Inform, & Lead NBCH’s Five Pillars and adopted by MichPHA: 1. Performance Measurement 2. Transparency and Public Reporting 3. Payment Reform 4. Informed Consumer Choice 5. Purchaser Leadership and Action Accelerating the pace to the ultimate goal: health and health care improvement

23. 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. 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. 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. 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)mhbell@michpha.org Visit us on the web at www.michpha.orgwww.michpha.org Join us September 23, 2010 Annual Conference “Local Healthcare Reform: Cost Containment Opportunities for Employers”