Through support from organizations like the National Alliance of Healthcare Purchaser Coalitions, corporate coalitions are driving community-based and statewide innovation in health outcomes, pricing and value, but significant challenges remain in transparency and support from community employers, said Neil Goldfarb, President and Chief Executive Officer of the Greater Philadelphia Business Coalition on Health (GPBCH).
GPBCH will hold a 10th anniversary event on November 10, 2022.
What have been the key challenges for GPBCH in increasing the value of healthcare?
I think one of the biggest challenges I alluded to in connection with the Leapfrog group is the lack of transparency in the healthcare system. So value is all about the relationship between quality and price, and many employers face the challenge of not having good access to information about quality and good information about prices.
Since we have helped as a coalition, [to] driving the transparency agenda forward, not just for hospital care but for other care settings, we know this has made a difference but there is much more to do. We don’t have very good transparency with doctors, for example. We are strongly committed to ensuring that primary care is the cornerstone of an effectively functioning healthcare system.
We currently do not have good information that is publicly available as to which primary care providers offer quality care. What are your results? What are the prices for the different services offered? How are primary care providers paid under the various health plans? And that’s why we still have a lot to do. If we want to add value and leverage our buying power, we need to start with more transparency about exactly what we’re buying and at what price. I think that’s one of the biggest hurdles.
I think the other big hurdle is that it’s great that as a coalition we’ve been successful in growing our membership, but for every member that we’ve recruited, we’ve probably spoken to 2 or 3 employers who have said, ” I don’t have time to be in a coalition” or “I really get what I need from my social worker” and who don’t see the value in employers coming together and all rowing through a coalition in the same direction.
So, for anyone out there listening who is an employer, if there is a regional coalition in your area, I urge you to speak to them and support them. Even if you can’t go to meetings or educational programs, your coalitions work for you every day, and they influence policy, they influence quality in your market, they implement and improve safety measures, and this benefits you employees and your program. So every employer owes it to their regional coalitions – not just GPBCH, but other coalitions across the country – employers owe it to show their support for those coalitions because those coalitions strongly support them.
GPBCH and nearly 50 other regional coalitions are members of the National Alliance of Healthcare Purchaser Coalitions. How has this relationship helped your coalition advance its mission?
The National Alliance of Healthcare Buyer Coalitions (National Alliance) is a national organization of which we are a member as a regional coalition, and its mission parallels ours: bringing coalitions together to work on the big issues in healthcare and hopefully help employers and their coalitions promote value. One of the most important things the National Alliance does, which I really appreciate, is that it brings us all together to learn from each other.
So, I have a staff of 2 other people. I can only take on a limited number of projects at a time. Other coalitions, our sister coalitions, are working on other important issues; Some of them are working on the same things as us, but many of them are working on different topics. And the National Alliance brings us all together so we can learn from each other, we can adapt each other’s tools and approaches to add value, we can learn not only from successes but also from failures so we don’t spend a lot of time , to replicate something that is unlikely to be successful. So that, to me, is the biggest benefit of the National Alliance, this learning network.
The other part of it is that the National Alliance represents us at the national political level. As many viewers know, there is so much going on in Washington, DC, and in many states and localities right now in terms of healthcare policies, price controls, access to care, surprise bills, all sorts of issues.
The National Alliance serves as a trusted source of policy updates, things to think about, how policies might affect coalitions and their employers’ members, and gives us the opportunity to sign many letters of law advocating policies in the interests of ours Employer Members. So I think the National Alliance is a really important resource that we can turn to for information, knowledge, political support, and collaboration with other coalitions to transform the value of healthcare
As healthcare advances, what role will coalitions play in managing employee health in the future?
I think coalitions will always play a role. Employer-financed health insurance does not appear to be disappearing anytime soon. And so, employers continue to be challenged by the rising cost of healthcare, the ongoing problem of lack of transparency, and the need to influence the healthcare system, which they find difficult to do alone. Coalitions create value through an employer-funded healthcare system.
But even if employer-sponsored insurance went away, let’s say the federal government said, “We’re going to have Medicare for everyone,” and the role of employers is basically to support that through taxes, even then, employers still have to health of their workforce. The workforce, not just the direct costs, but also the indirect costs – lost productivity, absenteeism and presenteeism, workers’ compensation claims, long and short-term disability claims.
Regardless of what happens to the structure of the healthcare system, I believe employers need to stay in the game, at least on the employee health and community health side. So I’m not worried about the future of the coalitions. I think they play a crucial role and whatever happens to the healthcare system we’re always going to need quality watchdogs and making sure quality isn’t lowered to save some money.
So I’m really proud of what we’ve done and I think the future is bright for coalitions and I would hope that they are able to increase their direct impact on health outcomes and on pricing or value to demonstrate.