Monday, November 23, 2015

Pacific Business Group on Health Receives 2015 Membership Award from NBCH

Coalition recognized for leadership role in public reporting, payment reform and quality measurement

DALLAS – Nov. 18, 2015 – The Pacific Business Group on Health (PBGH) was honored with the 2015 Membership Award by the National Business Coalition on Health (NBCH) for their leadership and efforts to work with purchasers across the country in collaboration with health plans and providers to improve quality and value in the US health system.

Lauren Vela, Sr. Director, Member Value for PBGH, accepts the award from NBCH CEO Charles Smithers and Karen van Caulil, NBCH Board Chair and President and CEO of the Florida Health Care Coalition.

A non-profit business coalition focused on improving the quality and affordability of health care, PBGH represents 60 large health care purchaser members with more than 10 million employees, retirees and dependents in California.

“PBGH is proud to be honored for the work we do on behalf of, and alongside our members,” said David Lansky, president and CEO of PBGH. “We have the great fortune of working with forward thinking purchasers who are dedicated to improving the value and outcomes of health care for their covered populations and health care consumers nationwide. On behalf of our members we would like to thank NBCH for recognizing our efforts to transform US health care.”

The coalition demonstrated leadership particularly in the areas of value-based purchasing initiatives and innovative benefit design strategies. Key PBGH policy programs include:
· Leveraging the clout of large purchasers to improve quality measurement
· Public reporting of provider and health plan performance information
· Collaborating with public officials to inform development and implementation of innovative payment and delivery reform policies
· Aligning public sector efforts with private purchaser activities to support comprehensive, system-wide transformation

Specific payment reform efforts in 2015 include recruiting large self-insured employers into state-based multi-payer initiatives, as well as the creation of a nation-wide Purchaser Value Network (PVN) to harvest and spread best practices in payment reform among public and private purchasers across the country.

PBGH also works with federal and state policymakers to facilitate the use of innovative benefit design strategies among its broader membership base. In 2015, this effort has included shaping implementation of the excise tax on high cost employer-sponsored health insurance plans, alignment of EEOC wellness regulations with the goals of the Americans with Disabilities Act, and clarification of recent HHS guidance on embedded out-of-pocket limits. The policy team also works with the administration to identify and remove regulatory barriers to value-based insurance design and purchasing initiatives like the Employer Centers of Excellence Network (ECEN).

PBGH engages both its members and the broader purchaser community in the performance measurement and reporting enterprise through the Consumer-Purchaser Alliance. The Alliance regularly develops education and advocacy materials for purchasing organizations and disseminates that information through email alerts, a periodic newsletter, website updates, webinars, traditional press, public comment letters, and social media.

“As health care costs continue to rise, coalitions are playing a critical role in reforming the system through community collaboration and purchasing strategies to improve the quality and value in care delivery,” said Karen van Caulil, NBCH board chair and president and CEO of the Florida Health Care Coalition. “We congratulate PBGH on receiving this well-deserved recognition for their efforts to improve health and health care.”

About the Pacific Business Group on Health
PBGH is a non-profit business coalition focused on improving the quality and affordability of health care. The group represents 60 large health care purchaser members with more than 10 million employees, retirees and dependents in California. Follow on Twitter: @PBGH_updates

About the National Business Coalition on Health
National Business Coalition on Health (NBCH) is a national nonprofit membership organization of purchaser-led health care coalitions, representing more than 7,000 employers, unions and local governments, and approximately 35 million employees and dependents across the United States. NBCH and its members are dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. NBCH seeks to accelerate the nation’s progress toward safe, efficient, high-quality health care and the improved health status of the American population. Follow on Twitter: @NBCH
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McKesson Honored by NBCH for Leadership in Building a Culture of Health

Award recognizes McKesson’s value-based benefit design efforts and effective wellness program

DALLAS – Nov. 18, 2015 – McKesson Corporation was presented with the Employer Excellence Award at the National Business Coalition on Health’s (NBCH) annual conference. McKesson was recognized for leadership and efforts to improve the health and wellness of employees while creating a health care system focused on lower costs, higher quality, and better health for all.

“While we’re in the business of better health, our commitment starts with our workforce,” said, Jerry Warren, Senior Vice President, Total Rewards, McKesson. “We strongly believe that making investments in our people and community is not only good for business, but also benefits the communities where our employees live and work. Our health and wellness program successfully promotes the physical, mental, and social well-being of our employees and their families. We have improved their health, while also creating opportunities to lower health care costs for our company, our employees and their families.”

Neil Oktavec, Manager, Benefits Strategy & Analytics for McKesson Corporation, accepts the award from NBCH CEO Chuck Smithers; Robin Turpin, Director, U.S. Health Delivery Systems, Takeda Pharmaceuticals; Karen van Caulil, NBCH Board Chair, Pres. and CEO Florida Health Care Coalition; and Lauren Vela, Sr. Director, Member Value, Pacific Business Group on Health
Offered to employees and spouses, McKesson’s health and wellness program is powered by Vitality and includes health risk assessments and screenings, educational tools, physical activities and prevention efforts. The program has had increased employee engagement each year since its inception in 2007 and has evolved from a payout for completed health assessments into a comprehensive health promotion program with an integrated incentive structure that rewards participants for healthy behaviors. Through Vitality, employees engage in approximately 80 healthy activities each year.

Employees have become more highly engaged as a result of McKesson’s key programs that involve incentives, value-based benefit design and consumer-driven health plans. The result has been higher achievements in health including:
  • Employees are engaged with 90% participating in the wellness program at some level.
  • A 5% lower medical cost trend (resulting in over $4 million in savings in one year) was reported for those highly engaged in the wellness programs over the last five years relative to those not highly engaged.
  • Approximately 85% of employees in a health plan have done the health risk questionnaire in the last two years, over 60% biometric screening, and over 40% of the population has verified physical activity through the wellness program.
  • For disease management, 25-30% of McKesson’s chronic population have engaged in programs over the last four years, a 10 times increase from prior periods.
  • McKesson measures population risk through many metrics, such as Vitality Age (measure of lifestyle risk) and DxCG risk scores. In 2011, 83% of McKesson’s eligible population had a Vitality Age that was older than their chronological age. In 2013, results were at 77%.
McKesson’s vendors are also required to have skin in the game. Approximately $3 million (20%) of self-insured health plan fees are at risk, mostly on risk adjusted cost results. More efficient plans get lower employee premiums gaining significant market share. Wellness, condition management, and transparency vendors have often 35%-100% of fees contingent on reaching certain aggressive engagement milestones and ROI.

“McKesson has an impressive history of being at the forefront of health care innovation, said Charles Smithers, NBCH CEO. “They are an excellent example of an employer committed to improving the health care delivery system and health of their employees. We applaud their efforts and congratulate them on receiving this award.”

NBCH’s Employer Excellence Award is sponsored by Takeda. McKesson is a member of the Pacific Business Group on Health.

About McKesson Corporation
McKesson Corporation, currently ranked 11th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. McKesson partners with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit

About the National Business Coalition on Health
National Business Coalition on Health (NBCH) is a national nonprofit membership organization of purchaser-led health care coalitions, representing more than 7,000 employers, unions and local governments, and approximately 35 million employees and dependents across the United States. NBCH and its members are dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. NBCH seeks to accelerate the nation’s progress toward safe, efficient, high-quality health care and the improved health status of the American population. Follow on Twitter: @NBCH
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Monday, October 19, 2015

Health at work and community tightly linked: New employer engagement tool

Health at work and in the community is tightly linked. Unhealthy communities can compromise employer investments to improve employee health and productivity and present an economic barrier to product consumption and economic investments.

A healthy community, on the other hand, may be more desirable to live and work and therefore, good for business. For several years the National Business Coalition on Health (NBCH) has facilitated engagement between employers and community stakeholders in population health improvement strategies. NBCH has supported community health grant projects, provided technical assistance, and developed educational materials for business coalitions and partners.

This newly-developed engagement tool helps coalitions partner with local employers and other stakeholders to improve health in their communities. It includes:
  • Assessment of an employer’s priorities and why they might want to participate in community-level health improvement activities
  • Results from County Health Rankings, ranked by local opportunities for improvement relative to the national average
  • Potential next steps and resources
  • Employer case studies
  • Financial impact analysis framework and calculator
More information, including links to the tool and an informational webinar, is available here. This project was conducted with support from the Robert Wood Johnson Foundation’s County Health Rankings and Roadmaps Program. The tool was developed by Discern Health.

Wednesday, October 7, 2015

Spotting Value in Your Benefits Program

NBCH recently participated in the Mediaplanet’s latest “Employee Well-Being” campaign that features industry influencers, organizations and advocates to highlight the importance for employers to prioritize the overall well-being of their employees through the improvement of health care and benefits programs. 

The campaign was distributed in an edition of USA TODAY, and will be available at our upcoming annual conference (Nov. 16-18, Fairmont Dallas).

Chuck Smithers contributed a piece on value-based benefit design : And here's a link to all of the other workplace health and wellness articles:

Wednesday, September 23, 2015

Kaiser Family Foundation Survey: Health Insurance Deductibles Outpacing Salaries

This week the Kaiser Family Foundation/Health Research & Educational Trust (HRET) released its 2015 Employer Health Benefits Survey, an annual survey of employers that provides a detailed look at trends in employer-sponsored health coverage including premiums, employee contributions, cost-sharing provisions, and employer opinions.

The research found that single and family premiums for employer-sponsored health insurance rose an average of 4 percent this year, continuing a decade-long period of moderate growth. Since 2005, premiums have grown an average of 5 percent each year, compared to 11 percent annually between 1999 and 2005.

The study also found that the average annual premium for single coverage is $6,251, of which workers on average pay $1,071, and the average family premium is $17,545, with workers on average contributing $4,955.

Laurel Pickering, chief executive, Northeast Business Group on Health, and David Lansky, chief executive, Pacific Business Group on Health, weighed in on the research for an article written by Reed Abelson, a reporter for The New York Times.

Tuesday, September 8, 2015

Sept. 9 Webcast - Cancer in the Workplace: How Employers Can Help

On Wednesday, September 9 from 1-2 p.m. Eastern, NBCH is hosting a webcast for employers and coalitions addressing cancer in the workplace.

Two presenters will share real experience from worksites identifying evidence-based strategies to improve the benefits and resources for employees living with cancer.

Register here.

Over the last year Pfizer, in partnership with Cancer and Careers, has worked with a steering committee of experts to explore the topic of breast cancer and the workplace as part of the Breast Cancer: A Story Half Told program. The organizations recently commissioned a national survey examining the perspectives of working women with breast cancer, health care professionals and employers. This surfaced a number of important findings about how women living with breast cancer feel about working while undergoing treatment, and how employers can better support these women through improved communication.

As the challenges associated with working following a cancer diagnosis are not unique to breast cancer, Pfizer has also collaborated with several organizations to develop an additional resource, Workplace Transitions, This is a free program that provides information and tools to help support communication between employers and employees to ensure a healthy and productive workplace.

Friday, August 28, 2015

NBCH announces speaker lineup for Annual Conference

An impressive group of forward-thinking thought leaders focused on the future of health care and benefits will be speaking at NBCH's Annual Conference, an event that convenes employers, business and health coalitions, health plans, providers and other stakeholders. This year's 25th anniversary event will be held at The Fairmont in Dallas, November 16-18, 2015.

Keynote speakers are David Goldhill, author of “How American Health Care Killed My Father,” and President and CEO of the Game Show Network; Jeffrey Bauer, Health Futurist and Medical Economist; Mark Caron, CEO, Geneia; and James Klein, President, American Benefits Council.

The event brings together an extensive group of health care stakeholders focused on best practice strategies to improve health outcomes, shrink excessive costs by benefit design, enhance care management, and reduce waste in the post-Affordable Care Act environment.

Additional speakers for this event include:
  • Larry Boress, President & CEO, Midwest Business Group on Health 
  • Kim Dwyer, Vice President, Benefits, Advocate Health Care 
  • Cyndie Ewert, Vice President for Human Resources / Benefits, Energy Future Holdings 
  • Gaye Fortner, CEO, Healthcare 21 Business Coalition 
  • Paul Fronstin, PhD, Director, Health Research & Education Program, Employee Benefit Research Institute 
  • Susanne Gensch, Wellness and Recognition Program Manager, Ericsson 
  • Barbara Gniewek, Principal, PwC US 
  • Neil Goldfarb, President & CEO, Greater Philadelphia Business Coalition on Health 
  • Emma Hoo, Director, Pacific Business Group on Health 
  • Bob Ihrie, Senior Vice President of Compensation & Benefits, Lowe's 
  • Cheryl Larson, Vice President, Midwest Business Coalition on Health 
  • Tom Lenhart, RPh, Vice President, Magellan Rx 
  • Jack Mahoney, MD, Chief Medical Officer, Florida Health Care Coalition 
  • Francois Millard, Chief Actuarial Officer, The Vitality Group 
  • Sandra Morris, Senior Manager of U.S. Benefits Design, Procter & Gamble 
  • Tom Parry, PhD, President, Integrated Benefits Institute 
  • Olivia Ross, Associate Director, Pacific Business Group on Health 
  • Bruce Sherman, MD, FCCP, FACOEM, Employers Health Coalition 
  • Dexter Shurney, MD, Chief Medical Director and Executive Director, Global Health & Wellness, Cummins 
  • Charles Smithers, Interim CEO, National Business Coalition on Health 
  • Thomas Sondergeld, Vice President Global Benefits & Mobility, Walgreens Boots Alliance 
  • Michael Thompson, Global Human Resources Services, Principal, PwC US 
  • David Toomey, Chief Revenue Officer, Compass 
  • Karen van Caulil, NBCH Board Chair and President , Florida Health Care Coalition 
  • Lisa Woods, Senior Director Health Care Benefits, Walmart
Registration is complimentary for all employers affiliated with an NBCH member coalition. For additional details and to register for the conference, visit NBCH’s website:

Tuesday, June 30, 2015

New NBCH Action Brief: Obesity (Update 2015)

More than one-third of U.S. adults and approximately 17% of children and adolescents are obese (a body mass index over 30). Employers must act now to mitigate the cause for overwhelming health care costs and loss of productivity associated with obesity. Employers can play a key role in improving the health and well-being of their workforce.

Read the full Action Brief by clicking on this link.

Thursday, June 25, 2015

King v Burwell Ruling

Today the Supreme Court ruled (6-3) that the federal health insurance subsidies shall remain available to individuals in the 37 states using This decision means that the major coverage provisions of the Affordable Care Act will proceed as planned. 

Here are links to recent headlines and resources on the topic:

Wednesday, June 17, 2015

NBCH Launches National Risk Solution Purchasing Program

First initiatives focus on significant costs drivers: pharmacy benefits and
musculoskeletal management

WASHINGTON – June 17, 2015 – After payroll, health care benefits are the largest cost for most industries and coupled with the pending excise tax and current reform landscape, it’s more critical than ever for employers to focus on value-based benefits programs to achieve better health at lower costs. To help employers accomplish this, the non-profit National Business Coalition on Health (NBCH) is launching two risk solution programs focusing on pharmacy benefits and musculoskeletal management.

“We’ve focused on two areas that make up a significant share of health care costs,” said Charles Smithers, Interim CEO for NBCH. “By circumventing conventional purchasing/delivery arrangements and focusing on some of the most corrosive aspects of health care costs, we believe we can help employers recover much of this excess, with better health outcomes.”

A partnership has been established with National Employers' Choice Rx. Structured differently than most PBMs, National Employers' Choice Rx is focused on reducing hidden fees, uses an evidence-based formulary based on independent studies, and offers a narrow pharmacy network. In addition to higher quality, a savings of 15-25% with a health care spend reduction of 2-3% is estimated when compared to conventional PBMs.

“We’re committed to this product and the transparency it produces,” said Mike Evans, Director of Benefits at OK Foods Inc. and current National Employers’ Choice Rx client. “There is absolutely no other pharmacy benefit program that can compare in quality and cost savings to employers.”

The second program is with Integrated Mechanical Care, a musculoskeletal management group that uses evidence, analytics, and proprietary guidelines to resolve orthopedic conditions, minimize lost work time, and reduce pain and disability recurrence rates by more than 80%. IMC’s program offers enhanced health outcomes in half the recovery time, with guaranteed savings of at least 25%. Since orthopedic conditions are typically 10% to 20% of the total health spend, employers can realize benefit plan savings of 2.5% to 10%.

These services are available for employers through NBCH’s regional coalition members. NBCH plans to extend these risk solution services to other areas including cardiometabolic care, infusion, dialysis, advanced imaging, ambulatory surgery, large claims audit, high performance networks, and centers of excellence. For additional information or to participate in one of these programs, please contact Sara Hanlon, Vice President, Risk Solutions for NBCH, via email,

"While it’s often said that health care is local, purchasers can benefit from national approaches that are value-driven with high expertise,” said Sara Hanlon. “These services can produce better health outcomes and reduce costs significantly, disrupting conventionally excessive care and cost. The real message to purchasers and health care professionals is that there are alternatives that can let purchasers recover the unnecessary costs they have assumed could not be challenged.”

About National Business Coalition on Health
National Business Coalition on Health (NBCH) is a national nonprofit membership organization of purchaser-led health care coalitions, representing more than 7,500 employers, unions and local governments, and approximately 35 million employees and dependents across the United States. NBCH and its members are dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. NBCH seeks to accelerate the nation’s progress toward safe, efficient, high-quality health care and the improved health status of the American population.
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NBCH Elects New Board Officers

NBCH announced its slate of new officers for the Board of Governors. Officers are elected by their board peers based on proven leadership and commitment to NBCH, as well as their efforts to advance and strengthen value-based purchasing strategies.

Additionally, Charles Smithers, COO for NBCH, was named Interim CEO.

Elected executive committee members include: Chair Karen van Caulil, Florida Health Care Coalition; Vice Chair, Gaye Fortner, HealthCare 21 Business Coalition; Secretary-Treasurer, Marianne Fazen, Dallas-Fort Worth Business Group on Health; and Representatives Larry Boress, Midwest Business Group on Health, and Anne Ladd, Wyoming Business Coalition on Health.

At-Large Representatives newly elected to the NBCH Board of Governors include: Jessica Brooks, Pittsburgh Business Group on Health, and Neil Goldfarb, Greater Philadelphia Business Coalition on Health. Current At-Large Board member Laurel Pickering, Northeast Business Group on Health was re-elected to serve a second term. Cheryl DeMars, The Alliance; Beverly Rossmiller, Tri-State Health Care Coalition; Cheryl Tolbert, Louisiana Business Group on Health; and Christie Travis, Memphis Business Group on Health, will continue their board terms.

“As health care purchasers continue to look for ways to impact the quality and cost of care, NBCH and its member coalitions are playing an increasingly vital role in providing tools and education,” said Karen van Caulil, PhD, President and CEO of the Florida Health Care Coalition. “I look forward to working with my colleagues from across the country to move this agenda forward and also welcome Chuck to his new role of Interim CEO. We appreciate his willingness to assist in NBCH’s transition to new leadership.”

Tuesday, June 9, 2015

Midwest Business Group on Health Releases Annual Employer Survey on Specialty Pharmacy

Today the Midwest Business Group on Health (MBGH) released the results of its fourth annual survey on specialty drug management finding employers are considering unconventional strategies to manage double-digit cost increases while shifting more cost to employees.

Although the vast majority of employers (88%) still rely on traditional plan designs (co-pays and coinsurance), many are ready to focus on new and novel approaches to managing specialty drugs costs.

Survey results indicate a significant number of employers (68%) are considering using a narrow network to manage patients, while less than 10% offer one. In addition, with 16% carving out their specialty drug benefit, 63% are considering moving towards this strategy. The biggest trend, however, is cost shifting. Over half of employers are considering shifting more costs to employees with 18% already doing so. In addition, 43% of the employers who shifted costs over the last three years, increased them by 50% in 2014.

Additional findings are included in the news release and supporting slides which can be found on MBGH’s website.

PopHealth Week Radio Podcast Launched

Last month Gregg Masters (@2healthguru), Fred Goldstein (@fsgoldstein), and Doug Goldstein (@eFuturist) launched PopHealth Week, a weekly radio podcast focused on all things population health.

Broadcast each Wednesday at 12 p.m. Eastern the show features people, topics, news and analysis, presents the broad spectrum of what is and is not population health and how it fits into the changing health and health care landscape.

The website is

Tuesday, June 2, 2015

WSJ: More Health-Care Insurers Seek Big Premium Increases

On Monday the Obama administration published more information about hefty premium increases for 2016 sought by large insurers selling plans under the health law.

An article in the Wall Street Journal by Louise Radnofsky and Stephanie Armour reported major carriers from around the country are proposing big increases in the premium rates paid by consumers who buy insurance policies on their own.

Noted in the article which can be found here
Blue Cross and Blue Shield of Illinois is looking to raise rates by averages of 29% or more. In Pennsylvania, Highmark Health Insurance Co. is asking for 30%, according to proposals submitted by insurers for the year ahead. Around the country, some of the main market leaders are looking for double digit increases.
The new requests for premiums come at a time when the political and legal future of the law hangs in the balance. The Supreme Court is set to issue a decision later this month on the validity of the law’s tax credits to offset the cost of premiums for lower-income consumers in most states in the country. 

Wednesday, May 27, 2015

The Commonwealth Fund: The Problem of Underinsured, Rising Deductibles Make It Worse

A new report from The Commonwealth Fund was issued last week finding that 31 million people with health coverage in the United States were underinsured in 2014.

The share of working-age adults who had health insurance all year but were underinsured was statistically unchanged since 2010, after nearly doubling, from 12 percent to 22 percent, between 2003 and 2010. People are considered underinsured if they have had health insurance for a full year, but have high deductibles or out-of-pocket expenses relative to their income.

The study, The Problem of Underinsurance and How Rising Deductibles Will Make It Worse, is based on The Commonwealth Fund’s Biennial Health Insurance survey, which interviewed people 19-64 years old between July and December 2014. It could not separately assess the effects of the Affordable Care Act on underinsurance because people insured all year in the survey had coverage that began prior to the law’s major insurance expansions going into effect.
The rate of growth in medical costs and insurance premiums has slowed in recent years. However, millions of consumers continue to be saddled with high out-of-pocket health care costs. While the number of underinsured people in the United States held constant in 2014, the steady growth in the proliferation and size of deductibles threatens to increase underinsurance in the years ahead.
The Affordable Care Act’s coverage expansions and protections have greatly improved the quality of insurance coverage available to people who lack job-based health benefits. In addition, cost-sharing subsidies significantly reduce deductibles for people with low incomes who buy plans in the marketplaces. But those subsidies phase out quickly, leaving families with deductibles that may be high relative to their incomes. In addition, the law has only limited ability to improve the cost protection of employer plans, which is the source of most American’s health insurance. 
Reforms and new approaches are needed to improve the cost protection of health plans. These could include innovations in benefit design that slow growth in deductibles and emphasize incentives that encourage people to utilize, rather than delay, timely health care. In addition, policymakers should identify and address holes in health plans—like out-of-network physicians in in-network hospitals—which are surprising many families with unexpected costs. Finally, systemwide efforts to lower the underlying rate of medical cost growth and share those savings with consumers will be critical.y had coverage that began prior to the law’s major insurance expansions going into effect.