Catalyst for Payment Reform

4 letters for your 2020 health care strategy (and Scrabble Score)

What do the letters V, Q, P, and D have in common? Besides being the remaining letters in your Scrabble tile holder – you know, the ones that you must either individually play to earn more points or they will be subtracted from your total points at the end of the game – they also can make or break your health care strategy, individually and collectively. Hear us out below.

V is for Value

The health care system continues to shift from traditional fee-for-service to new methods that pay for value. For example, CPR’s recently released Scorecard on Payment Reform 2.0 that measures value-oriented payments in three states shows that value-oriented payments have eclipsed the 50% and even 60% mark, depending on the state. How familiar are you with new, alternative payment methods? Do you know how many of your dollars are flowing through value-oriented payments, like shared risk or bundled payments? Employers have historically relied on health plans to adopt value-oriented payment strategies, so understanding where your organization’s precious health care dollars are going is a requisite. Asking questions during a request for proposal process or during your health plan check-in will result in you being more informed. Dictating that payments go to high-value providers (e.g. through a direct contract, center of excellence) is a step further.

Q is for Quality 

To achieve better value, employers can’t simply focus on cost; quality is an essential part of the equation. And getting access to standard quality measurement is still a challenge for employers (which is why we developed the Standard Plan ACO Report). How familiar are you with how quality is measured and reported, and its variation across providers? What have you done to educate your employees and their families about the differences between a low- and high-quality provider or what high-quality looks like? What is your health plan doing to improve quality? If you’re only laser-focused on health care costs, quality improvement is an overlooked and pivotal strategy to support cost management efforts.

P is for Personalization 

Employers continue to look for ways to personalize the benefits experience for an increasingly diverse population. There are myriad ways employers can personalize their benefits program resulting in employees that are engaged in both their work and benefits. It’s critical first to understand your population and its different segments, customizing as needed. Personalization can take the form of a tech-enabled or high-touch delivery method, a variety of benefits accommodating different demographics, or solutions to target specific conditions. How do you analyze and measure employee engagement? What programs are you considering offering to your members for a more personal experience? Are there opportunities for feedback built into the design and implementation process? Personalization can be viewed as a differentiator in the eyes of your most prized assets, your people.

D is for Disruption

 Change is a constant in health care as we continue to learn what works, what doesn’t, and try to adjust accordingly. CPR believes that employers can be agents for the change we desperately need in health care. Employers can combine forces with other health care purchasers through business coalitions or ask uniform questions during a competitive bidding process to send a consistent signal on employer priorities. They can comment on policy proposals to voice the employer perspective or participate in initiatives to promote public reporting or data sharing. Do you team up with other health care purchasers to increase your voice? Do you participate in initiatives outside of the employer health care domain? Do you disrupt the status quo by exploring and implementing new solutions? You have the power to disrupt with your individual purchasing decisions or by teaming with others to drive change.

What does that spell?

Just because VQPD doesn’t result in a neat acronym-word doesn’t mean you should discount it. CPR and Mercer have created The Vitals for Change Scorecard to help purchasers assess their knowledge and actions in each of these vital areas. Before you embark on next year’s strategy, invest the time to confirm your baseline measurements. It’s free, takes 15 minutes, and is as fun as a game of Scrabble (we may be a little biased)!

Leave a Reply