By Melina Kambitsi, Ph.D.
Transparency has been a buzzword in health care for some time. But what does it really mean? At The Alliance, we’ve always defined transparency as putting accurate, comparable and understandable information about health care cost and quality at employers’ fingertips. This enables them to share that information with employees and dependents to make informed decisions about their care.
It’s also about collaborating with health care providers on how we measure their performance so that we can reward them for value instead of volume. We can’t reward providers for value unless employers and consumers become active health care shoppers. And we know that won’t happen unless we help employers provide actionable information and help them align incentives for employees and their families to choose high-value providers.
Many employers are using transparency as a catalyst to make real change. The Alliance can help employers review their claims and utilization data to determine trends that can save money and help employees get the best care possible. For instance, one employer launched a care navigation program to encourage the use of high-value musculoskeletal providers that saved them close to $100,000. Another provided employee education around when to use different places of service after several employees used the ER for non-emergent services. All this couldn’t be done without access to their data and the analysis from The Alliance.
The Alliance also offers bundled payments as an option for outpatient services, like knee and hip replacements, and QualityPath® for inpatient services and testing. There are major swings in costs per episode of care from one network health provider to the next, and that provides an opportunity for cost savings if employers learn to harness this information.
The Alliance member organizations spend nearly $800 million on health care every year. Banding together to leverage this impact is one of the most effective ways to improve the value of health care. By using providers who deliver good care at a lower price, employers as health care purchasers can have a positive impact on health care cost and quality
Melina Kambitsi, Ph.D., is senior vice president business development and strategic marketing for The Alliance. To learn more, contact Melina at 800.223.4139 x6643 or email@example.com.
The Alliance (www.the-alliance.org) is an employer-owned, not-for-profit cooperative that moves health care forward by controlling costs, improving quality and engaging individuals in their health. Its more than 250 employer-members provide health benefit coverage to more than 100,000 people throughout the Midwest.