Moving toward quality, affordable care: First-hand perspectives
Business leaders share their experiences trying to move the needle on health care reform and cost control.
Dan Burke works with more than 20,000 employees as director of corporate benefits for Turner Industries Group in Baton Rouge, La. However, because about of quarter of the industrial contractor’s workers are in the Houston area, he also is the current chair of the Houston Business Coalition on Health.
“My focus has been on finding innovative solutions to help manage our self-insured medical plan,” he said. “We know that health care is very nuanced and also very local, with unique challenges that have to do with varying factors in each market, not to mention political and cultural factors in each market. In a perfect world, health systems would have to compete on cost and quality, but we are not there. We have never been there, and we are faced with health care costs that are unsupportable. What can we to begin to develop some collective influence to begin to turn the tide?”
Related: Lessons from COVID: Health care transformation starts when employers demand value
Burke participated in a panel discussion about Mobilizing Collective Action to Move the Market during the National Alliance of Healthcare Purchaser Coalitions’ 2021 Leadership Summit on June 7. His cooperative approach is just what it will take to move the needle on providing affordable, quality care, said Cheryl DeMars, president and CEO of the alliance who moderated the discussion.
“The vision we have for high-quality, affordable care is unachievable unless employers work together to have an impact in their communities and in policy,” she said. “That isn’t easy.” Gloria Sachdev is addressing this difficult challenge as president and CEO of the Employers Forum of Indiana.
“When everybody says health-care costs are so high, it is really either about price or utilization,” she said. “The forum has been focused on aligning payment with the value of services provided, and then adding to that holding the entire supply chain accountable. Where there is knowledge, there is power. The supply chain understands that fully, so they kind of keep purchasers in the dark intentionally. With a unified voice, you can have some power and strength in numbers.” When employers flex their muscles, they can drive real change, said Jessica Brooks, CEO and executive director of the Pittsburgh Business Group on Health.
“When employers initiate change, it lasts longer,” she said. “Our drug program that we have had for more than 20 years was started by a collective of employers who said, `we don’t think we will be able to afford these costs without working together.’ It was the employers who started this.”
The Houston Business Coalition on Health also is committed to making its voice heard. “Our intent is to have a respectful, meaningful dialogue with carriers and health systems to address a huge problem,” Burke said. “We need to reclaim our seat at the table and have willing partners to have those conversations. No single employer can really influence this. We can make a difference when we join forces with other large companies and have a conversation with the health systems to begin to make change.”
Along with employers being heard, they must hold the system accountable, Sachdev said. “A big surprise to me was all of the misaligned incentives,” she said. “I had no idea that the brokers, the benefit consultants, the PBMs and the insurance companies don’t have a fiduciary responsibility to the employer. They don’t even have to disclose the financial relationships that they have with other stakeholders. That’s an ethics 101 violation in my opinion, so we are encouraging all employers to hold the supply chain accountable.“
Brooks offered three practical ways to make this happen: “Use independent third parties to verify what is happening, highlight the impact on consumers and follow the lead of employers. We have to get outside our boxes and be creative.”
Finally, significant change is difficult without cooperation from both leadership and employees. “At the end of the day, you have to be able to show how health care is impacting your business and how it affects the bottom line,” Burke said. “It’s vital that we get senior leadership involved, because people who sit in my seat can and have been screaming about this for a decade or more, and we see where it has gotten us. Without C-suite buy-in, we really can’t make a difference.
“And if you are looking to avoid disruption to your employees, you can’t make any meaningful change. It’s really important to keep your employee base up to speed on what’s going on.” DeMars encourages employers to roll up their sleeves and do the hard work that will be necessary to bring about change.
“There is lots of resistance to changing the status quo, and collective action isn’t easy,” she said. “It’s hard to truly collaborate. It takes more time, more energy, a shared vision, trust and a willingness to compromise.”
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