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Four Core Drivers of High-Value Health Care: Transparency
By Melina Kambitsi, Ph.D., SVP, Business Development and Strategic Marketing

As a follow-up to our article on the four core drivers of high-value health care, we aim to go deeper into transparency to help employers get more value from their health benefit investment and help drive real change in the market.

Transparency has been a buzzword in health care for some time. But what does it really mean? At The Alliance, we’ve always defined it 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 about 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. After years of advocacy on behalf of our members in this arena, we firmly believe this is key to driving change for the better at hospitals and clinics.

Transparency in Action
Many Alliance employers are using this as the 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 services after a number of 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.

We also offer bundled payments as an option for outpatient services and QualityPath® for inpatient services and testing.  We know that transparent cost information is only half the battle, but believe it is preferable to choosing health care in a void. There exist 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.

Quality measurement in health care has come a long way. Still, gaps remain between the information we need and what is available today. We are evaluating quality information from both publicly available and commercial sources and will soon invest in new, meaningful quality indicators to add to our comparative price information used by employers. Our health policy advocacy at both the state and federal levels aims to advance and accelerate these efforts.

What Can Employers Do?
Consumers want answers to questions about health care options, how much they cost, and where to go for safer, quality care. The Alliance wants to help them find the answers. To learn more about how The Alliance works with employers to make health care more affordable, contact us.

Melina Kambitsi, Ph.D., SVP, Business Development and Strategic Marketing at The Alliance
Melina Kambitsi joined The Alliance in 2017 and leads the team responsible for membership growth and retention of the cooperative. Previously, Dr. Kambitsi was chief sales and strategy officer at Network Health in Milwaukee and Menasha, WI and senior vice president of sales at Blue Cross Blue Shield in Honolulu, WI. Dr. Kambitsi received her bachelor’s in international studies and her master’s and doctorate degrees in economic geography at The Ohio State University.
 

 
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