This is the fifth year that the National Business Coalition on Health has been honored to co-sponsor Modern Healthcare's annual Healthcare Purchasing Power Survey along with the Leapfrog Group. The release of the survey results coincides annually with our conference where, this year, the NBCH is celebrating its 20th anniversary as a not-for-profit organization of purchaser-led business and health coalitions.
I've recently been reflecting on the past two decades of our organization's role as a national umbrella group for employer-based health coalitions, and the opportunity to write this commentary on purchasing comes at a perfect time.
Please indulge me in a brief history lesson about purchasing coalitions and our core beliefs. The first, now widely recognized but little appreciated when we all first started, was that employers have an interest and an influential role to play in improving health and healthcare. Each employer, whether in the public or private sectors, is highly motivated to pursue strategies to improve the health and productivity of their workforce and to maximize the value of each dollar spent on employee health benefits. Moreover, success in realizing those two goals advances the mission and competitive advantage of each employer. Improving health and healthcare is good business.
A second belief at the core of purchaser-led coalition development, and ultimately the NBCH's creation, was the notion that no one employer has the influence and leverage to significantly improve health and healthcare, and that much could be gained by employers coming together and taking action as a unified group.
A related belief was that without collective employer leadership challenging the status quo, the prospects were dim for genuine reform and progress. The healthcare market has been impacted by an extraordinary mix of purchaser-led activities, including group purchasing arrangements, direct contracting with provider networks, health plan performance assessment initiatives, data-warehousing projects, public report cards on provider performance, value-based insurance design and payment reform projects, public policy advocacy and best-practice sharing and education.
A third belief was that, like politics, all health and healthcare is local. Informed by an understanding of the significant geographic variations in disease prevalence, healthcare utilization, quality of care, and the social and environmental determinants of health status, coalition leaders are committed to organizing strategies and solutions that fit the unique circumstances, characteristics and even cultures of their communities. No one size fits all.
Finally, our organization was established by a belief that much could be gained if employer leadership came together as a community sharing a common bond and mission in advancing the triple aim of better health, better healthcare and lower cost. Coalitions have demonstrated the value of building learning networks among their 7,000 employer members, the power of peer learning and the spread of best-practice strategies among coalitions across the nation.
Looking to the future for purchasers, these core beliefs will continue to serve as the key pillars for the work of coalitions. While the health and healthcare environment has continued to evolve, particularly with the advent of the landmark national healthcare reform legislation, the focus on the important role of employers and employer-based coalitions as catalysts for meaningful change will continue.
Indeed, if I could offer any words of encouragement to those on the frontlines working to improve health and the quality and value of healthcare in their local markets, it would be to “keep your eyes on the prize.” By this I mean that the overarching goals of improving workforce and community health and getting the most value for healthcare expenditures must remain the guiding vision.
Also impervious to change are the core strategies purchasers have deployed to improve health and healthcare, namely population health management and value-based purchasing. A population health strategy shifts the paradigm from treatment of illness to impacting all the determinants of health, including environmental, socio-economic, and individual behavioral factors that sit outside the traditional healthcare delivery system.
A value-based purchasing strategy refocuses attention on measuring, reporting and rewarding excellence in healthcare delivery, from the value and effectiveness of each healthcare intervention to the performance of each healthcare provider. This constancy of purpose, namely identified aims and a strategic path to get there, will continue to serve purchasers well in the years ahead.
As NBCH celebrates its 20th anniversary, we'd like to pay tribute to the hard work of the purchasing community, acting as catalysts for change and for blazing the trail in population health management and value-based purchasing. We look forward to the next two decades of working with purchasers to continue efforts to change health and healthcare for the better in our nation.
Andrew Webber is president and CEO of the
National Business Coalition on Health, Washington.