Tuesday, September 30, 2014

Forty Percent of Payment to Physicians and Hospitals in the Commercial Sector Today is Designed to Improve Quality and Reduce Waste

Catalyst for Payment Reform (CPR) today released the 2014 National Scorecard on Payment Reform. The 2014 version of this annual Scorecard indicates commercial health plans have dramatically shifted how they pay physicians and hospitals, with 40 percent of their payment now designed to encourage health care providers to deliver higher-quality and, in some cases, more affordable care.

The National Scorecard on Payment Reform uses data submitted by commercial health plans on a voluntary, self-reported basis to eValue8, the National Business Coalition on Health’s annual request for information to health plans. The plans responding to the Scorecard questions represent 65 percent of the commercially-insured lives in the U.S.

You can read more about the 2014 Scorecard here and access the complete Scorecard online.

Friday, September 26, 2014

NBCH Member Coalition News: Washington Health Alliance

The first statewide report in the nation to measure Choosing Wisely® recommendations finds that patients in Washington may be exposed to care that they don’t need—and potential harm. The report, Less Waste, Less Harm: Choosing Wisely in Washington State, offers county-by-county results for nine different Choosing Wisely recommendations.

The results are based upon claims data representing 3.3 million lives in Washington state and was issued by the Washington Health Alliance (the Alliance) in conjunction with the Washington State Choosing Wisely Task Force, a group of more than 20 medical leaders from the largest health care organizations in the state. The Task Force is co-sponsored by the Alliance, the Washington State Medical Association (WSMA) and the Washington State Hospital Association (WSHA).

Read the full press release here.

Thursday, September 25, 2014

Employers and Key Stakeholders Focused on Improving Health and Health Care, Reducing Waste and Costs, and Payment Reform at NBCH Annual Conference

WASHINGTON– September 26, 2014 – The National Business Coalition on Health (NBCH) will bring together more than 400 purchasers, business and health coalitions, plans, providers and other stakeholders for its 19th Annual Conference – Employers Transforming Health Care: The Power of Collaboration. The event will be held at the Marriott Wardman Park in Washington, November 10-12, 2014 and features Shawn Leavitt, Senior Vice President, Global Benefits, Comcast, as opening keynote.

NBCH is a national, non-profit, membership organization of 54 business and health coalitions, representing over 4,500 employers and 35 million employees and their dependents across the U.S.

“Most health care purchasers have been remarkably passive in the face of skyrocketing health costs,” said Brian Klepper, PhD, Chief Executive Officer, NBCH. “By contrast, NBCH has taken an activist agenda and this meeting will display approaches that have consistently delivered far better health outcomes at lower cost. We believe that purchasers are hungry for these types of approaches that can recover health costs while improving results and drive better value throughout all of health care.”

Speakers for this event include:
  • Mary Bourland, VP, Medical Documentation, Medical Director of Compliance, Mercy Health Systems
  • Dan Crippen, Executive Director, National Governors Association
  • Jonathan Dugas, Director of Clinical Development, The Vitality Group
  • A. Mark Fendrick, Director, Center for VBID, University of Michigan
  • Grant Gordon, Co-Founder & CEO, Artemis Health AnalyticsDavid Gruber, Managing Director, Director of Research, Alvarez & Marsal Healthcare Industry Group
  • Ann Kirby, Assistant Benefits Manager, Hines
  • Robert Laszewski, President, Health Policy & Strategy Associates, LLC
  • Christian Moreno, Vice President, Health Risk Solutions, Lockton Dunning Benefits
  • Tyneeta Morris, Director, Human Resources, Greyhound Lines, Inc.
  • Mario Schlosser, Co-CEO and Co-Founder, Oscar Insurance Corporation
  • Joe Thompson, Arkansas Surgeon General, Arkansas Center for Health Improvement
  • Sally Welborn, Senior Vice President Global Benefits, Walmart Stores, Inc.

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: http://www.nbch.org/2014-Annual-Conference.

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 over 4,500 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. www.nbch.org

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Note to editors: A limited number of passes are available for accredited media upon request.

Tuesday, September 23, 2014

Bleak Future of Primary Care Access

Richard Young, MD

Published 9/22/14 in The Ft. Worth Star Telegram

Note from Brian: Richard Young, a primary care physician at John Peter Smith, a safety net health system in Ft. Worth, TX, has been an articulate and tireless explainer of the deeper health care dynamics that have undermined primary care and good health care for us all. See below.

Unfortunately, we have a preview in Dallas-Fort Worth and other communities of the effects of failed policies of Medicare/Medicaid, state government and insurance companies in how they value medical services and how they poorly support the first-contact primary care system.

Sunday, September 21, 2014

Developing A Coordinated, Considered Response to Predatory Health Care

Brian Klepper

In today's New York Times, Elizabeth Rosenthal describes the growing and egregious over-treatment and overpricing practices by physicians and health systems, abetted by health plans.

The excesses detailed in this article are at the core of our national health care quality and cost crisis. The best solutions are collaborative, considered actions by group purchasers, potentially the most empowered of health care's stakeholders.

When predatory anecdotes like these come to light, the benefits managers - or better yet, the CFOs - of local employers, unions and governmental agencies should immediately call the health plan and demand that the health systems, physicians and other providers involved be removed from the provider panel. (Small communities held hostage by a few dominant health care players are a separate topic that I'll address soon.)

As Tom Emerick, former VP Human Resources at Walmart has stated repeatedly, health care will not improve until purchasers demand different behaviors from health care vendors, focusing business on organizations that facilitate high quality care at reasonable cost, and publicly avoiding those that do not.

This is a serious issue that demands a coordinated response. It is at the top of NBCH's agenda. Join with us on this.

Wednesday, September 17, 2014

New Anthem Blue Cross plan takes on Kaiser

Taking aim at HMO giant Kaiser Permanente, insurer Anthem Blue Cross is joining forces with several big-name hospitals and their doctors to create an unusual health plan option for employers in Southern California.

The joint venture being announced Wednesday brings together seven rival hospital groups in Los Angeles and Orange counties, including well-known institutions Cedars-Sinai Medical Center and the UCLA Health System. The deal reflects the pressure insurers and hospitals alike are facing to hold down healthcare costs for employers and their workers.

Read the full article via the Los Angeles Times here.

David Lansky Addresses Pacific Business Group on Health's State-of-the-Art Travel Surgery Program

David Lansky, President and CEO of Pacific Business Group on Health, was recently interviewed by U.S. Domestic Medical Travel in regards to the coalition’s Employers Centers of Excellence Network (ECEN) which offers a state-of-the-art travel surgery program, and serves to provide patients with high quality, affordable healthcare. You can access the full interview here.

Tuesday, September 16, 2014

CMS to Continue Webinar Series on Reinsurance Contributions

NBCH thanks the American Benefits Council for the information provided in this post.

The U.S. Department of Health and Human Services (HHS) Centers for Medicare and Medicaid Services (CMS) will host the latest in a series of webinars on required Transitional Reinsurance Program (TRP) contributions under the Patient Protection and Affordable Care Act (PPACA).

Under PPACA, during the first three years that health insurance exchanges are operational (i.e., 2014 through 2016), health insurance issuers and plan administrators (on behalf of self-insured group health plans) will be assessed a per-enrollee fee to finance the three-year transitional reinsurance program. The fee is $63 per covered life for 2014.

HHS and CMS released guidance on the process for making TRP contributions in May, previewing "a streamlined process for the collection of reinsurance contributions" through Pay.gov. This issuance was followed by an initial series of webinars to provide an overview of policy and operations for reinsurance contributions, followed by a second series to provide an overview of how a contributing entity can submit its annual enrollment count and make reinsurance contributions through Pay.gov.

CMS has announced this latest webinar series to provide an overview of the "job aid" available to assist entities in the development of supporting documentation and detail how an entity can update reinsurance contribution filings through Pay.gov if an issue arises after submission. The new webinars will be held on the following days and times:
  • Wednesday, September 17, 2-3:30 p.m. ET
  • Friday, September 19, 2-3:30 p.m. ET
  • Wednesday, September 24, 2-3:30 p.m. ET
Registration will be on a first-come, first-serve basis, limited to three participants per organization. Registration will be limited to selecting only one of the event dates. You will need to log in to the official Registration for Technical Assistance Portal for more information.


NBCH Names Top Performing Health Plans According to 2014 eValue8 Results

Annual health plan survey and evaluation encourages transparency and accountability,
promotes quality improvement

WASHINGTON – September 16, 2014 – Kaiser Permanente Colorado was named the top performing health plan according to the 2014 eValue8 results released by the non-profit National Business Coalition on Health (NBCH). A critical element of purchasers’ value-based purchasing strategy, eValue8 is an annual health care accountability and quality improvement assessment used by employers and coalitions to manage the quality and efficiency of America’s health plans.

“We’ve incorporated eValue8 and the results into our RFI and procurement process,” said Kerry Schaefer, manager, Compensation & Benefits, for King County in Washington. “Plans can’t do well on an eValue8 survey unless they are putting a heavy emphasis on value-based benefit design.”

2014 benchmark plans
Plans who achieved the best performance (benchmark) among all insurers responding for specific modules include:
  • Physician and Hospital Management and Measurement – Aetna Washington
  • Helping Members Stay Healthy – Kaiser Permanente Colorado
  • Helping Members Become Good Consumers – Cigna CaliforniaHelping Members Manage Acute/Episodic Conditions – Cigna Connecticut and Group Health Cooperative
  • Helping Members Manage Chronic Conditions – Kaiser Permanente Colorado
  • Pharmaceutical Management – Kaiser Permanente Colorado
  • Business Practices – Cigna California
Additional details on the 2014 results and other top ranking plans can be found on NBCH’s eValue8 website. Participating NBCH member coalitions included the Colorado Business Group on Health, Healthcare 21 Business Coalition, Memphis Business Group on Health, MidAtlantic Business Group on Health, Northeast Business Group on Health, Pacific Business Group on Health and the Washington Health Alliance.

According to the NBCH Value-based Purchasing Council, savvy plans understand that buying health care on price alone is only a quick fix. While it might save some money in the short-term, it is neither a sound nor sustainable strategy to bend the cost curve. Value-based purchasing can help shift the paradigm of why employers offer health benefits, from seeing it as a recruitment and retention tool, to an opportunity to improve population health, increase productivity, and ultimately the employers’ bottom line.

“eValue8 helps purchasers understand the value of their investment in providing health benefits,” said Foong-Khwan Siew, Director eValue8 for NBCH. “The program advances value-based purchasing by measuring and reporting on year-to-year plan accountability.”

2015 survey release
The 2015 eValue8 survey will be available for health plans to complete in November. NBCH encourages purchasers and their consultants to ask their plans to respond to eValue8 2015 to assess the value of their investment.

About eValue8
An annual health care purchasing and quality improvement assessment process, eValue8 was created by business coalitions and employers like Marriott and General Motors to measure and evaluate health plan performance. eValue8 asks health plans questions about how they manage critical processes that control costs, reduce and eliminate waste, ensure patient safety, close gaps in care and improve health and health care.

NBCH believes that local business coalitions are key in facilitating multi-stakeholder collaborations at the community level to educate consumers, and improve quality and efficiency of the health delivery system. Purchasers interested in having their plans report performance in a variety of health services can contact NBCH or their local business coalition.

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 4,000 employers and about 35 million employees and dependents. 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.

NBCH’s 19th Annual Conference will be held November 10-12, 2014 in Washington. Additional details and registration information can be found here: http://www.nbch.org/2014-Annual-Conference.

Wednesday, September 10, 2014

Employer-Sponsored Family Health Premiums Rise 3 Percent In 2014

Average annual premiums for employer-sponsored family health coverage reached $16,834 this year, up 3 percent from last year, continuing a recent trend of modest increases, according to the Kaiser Family Foundation (KFF)/Health Research & Educational Trust (HRET) 2014 Employer Health Benefits Survey released today. Workers on average pay $4,823 annually toward the cost of family coverage this year.

Read more via Health Affairs Blog

Friday, September 5, 2014

Direct contracts with medical providers help self-insured employers control costs

A growing number of self-insured employers are bypassing health plan administrators and contracting directly with providers in efforts to limit the increases in their health care costs.

Direct contracting isn't new, but more employers are considering it among other cost-cutting measures, and many providers are better prepared to run the numbers.

According to Aon Hewitt's “2014 Health Care Survey,” conducted between December 2013 and January of this year, 11% of employers are engaging in some form of direct health care provider and service contracting during this plan year, and 28% expect to do so in the next three to five years.

Read the full story via Business Insurance here.

C-suite must band together to rein in health care costs

Steve Twedt's article today in the Pittsburgh Post-Gazette features comments from NBCH CEO Brian Klepper's keynote at the Pittsburgh Business Group on Health's annual symposium.

Dr. Klepper called on C-suite executives to band together if they are to overcome the power of the health care industry and to rein in health care costs.

"Business leaders need to develop a national health care data warehouse and analytics platform that will arm them with information showing which plans and providers produce the best value for the money as far as quality, safety and cost. They have to come together to work as one, to be a counterweight to the health care industry."

Wednesday, September 3, 2014

New NBCH Action Brief: Breast Cancer

Among American women, breast cancer is the most common non-skin cancer and the second leading cause of cancer death, exceeded only by lung cancer. In 2010, medical costs associated with female breast cancer were estimated at $16.5 billion - the highest cost for any cancer site - with total cancer costs in the United States amounting to nearly $125 billion. The significant financial burden of cancer, compounded with the emotional strain of diagnosis and treatment, can create a complex situation for employers. This Action Brief outlines the scope of breast cancer as well as how health plans are addressing the issues based on data from eValue8. Lastly, the brief highlights actions employers can take to improve breast cancer prevention strategies and to better support workers and dependents facing breast cancer diagnosis and treatment.

Access the lastest in NBCH's series of Action Briefs here.

Tuesday, September 2, 2014

Webinar: Access to Specialty Medications & Value-based Insurance Design

Join the National Pharmaceutical Council for a webinar on September 29 from 1:00-2:00 pm ET. NBCH's CEO, Brian Klepper, will present on the webinar along with a panel of other leading health and benefits experts. Read the webinar announcement from NPC below and register online today.
Specialty medications have been making health care headlines in recent months because of their effectiveness and higher costs. How can we ensure that patients will have access to the treatments that work best for them?

Join us for a webinar with a panel of leading health and benefits experts on Monday, September 29 at 1 pm ET. Our panel will discuss specialty medications and the use of tactics such as value-based insurance design (V-BID) by payers and purchasers as they develop their health care coverage options.

Speakers include:
  • A. Mark Fendrick, MD, Director, University of Michigan Center for Value-Based Insurance Design
  • Will Shrank, MD, Chief Scientific Officer and Chief Medical Officer, Provider Innovation and Analytics, CVS Caremark Corporation
  • Brian Klepper, PhD, Chief Executive Officer, National Business Coalition on Health
  • Moderator: Kimberly Westrich, MA, Director, Health Services Research, NPC
We’ll discuss:
  • The current health care environment and challenges with specialty medications and health benefit designs;
  • How V-BID could be utilized to address these challenges; and
  • The view from employers and steps they are taking to manage employee health.
For additional background on this topic, check out: