The NC Chamber has set an ambitious goal of making North Carolina a top-ten state for health and health care value – improved quality and outcomes at a predictable and reasonable cost. Value must drive purchasing as North Carolina’s health care costs are unpredictable and health outcomes remain below average.
This is a frustrating reality for job creators purchasing health care for their employees. While some are taking important steps to improve health and health care value for their workforce, there are not enough employers taking action to fix our broken health care supply chain. We need all of North Carolina’s employers to demand new ways of delivering and paying for better health and health care.
Transforming the system will require collaboration from stakeholders across the health care supply chain, including health care providers, third-party payers and job creators. The NC Chamber’s 2019 Health Care Conference not only showcased large-scale initiatives laying the foundation for systemic transformation over time, but provided examples of ways employers and others are improving health and health care value right now. Please read the latest NC Chamber Foundation report, “Turning Conversations into Action: Health Care Value,” so you can learn more about important changes under way and actionable steps your company can take to help make North Carolina a top-ten state for health and health care value.
Gary J. Salamido
President and CEO
Turning Conversations into Action: Health Care Value
Stakeholders along the health care supply chain gathered at the NC Chamber’s 2019 Health Care Conference to discuss health care transformation, major initiatives under way in the state, examples of employer-based strategies, and recommendations for employers. Key takeaways from these conversations include:
1. Health is about more than health care: While care certainly plays a role in maintaining the health of an individual or a population, lifestyle habits and social determinants (income, affordable housing, access to healthy food and more) play an even more important role for most people. Blue Cross and Blue Shield of North Carolina and the North Carolina Department of Health and Human Services shared specific strategies they are implementing to address social determinants of health. Duke Health System and Novant Health System also mentioned community-based efforts aimed at these factors.
2. Primary care is critical and needs more emphasis: Fragmentation, duplication and waste are issues that drive health care costs up and quality down. And, often at the root of these issues is a lack of appropriate primary care. A variety of organizations, including The Clinic at Biltmore, Cone Health and Wake Forrest Baptist Hospital described steps they’re taking to improve the quality of primary care and make it more accessible.
3. Behavioral health gaps need to be filled: From stress, anxiety and depression to social isolation and substance abuse, stakeholders recognize the need to increase focus on behavioral health. Mindpath Care Centers described initiatives targeting behavioral health needs, including programs to reduce the stigma of behavioral health problems, integration into primary care, and using virtual visits to reach underserved areas.
4. Need better data and better use of data: While there is still more work to do to change how health care is paid for, a critical component of that work is having access to and using data. Presenters emphasized opportunities for employers to use data to understand their populations and to design benefits and programs accordingly. But first, that data must be available.
5. To drive change, employers must send a strong and consistent signal to the supply chain: Presentations made it clear – the transformation from a fee-for-service to a value-based approach to health care is a very heavy lift for stakeholders willing to take the risk. Health care providers, health systems and third-party payers will move faster and more boldly if employers send clear and consistent signals that they want to buy value.
Actions Employers Can Take
Thankfully, there is momentum in North Carolina driving a value-based purchasing approach. Employers simply need to join those efforts. While tackling health care costs and demanding value seems daunting, there are a few simple steps employers can take that will make a major impact.
1. Use benefit design to promote high-value health care decision-making: Take a close look at plan design with special consideration given to the affordability of plans for lower-income workers and their families. Also, use plan design to incentivize high-value care, like primary care, behavioral health and the use of high-value prescription drugs. Data is also key to driving value. As you design benefits, demand your data, so that you know where your health care dollars are being spent. Value-based health care and insurance products are beginning to appear and will likely be more available next year for 2021. Make “value” a cornerstone of next year’s planning process.
2. Manage your health care supply chain: Businesses of every size and industry have supply chains that are integral to operations. These supply chains are managed closely because one segment greatly impacts the next. Unfortunately, the complexity of health care has kept most job creators from taking an active role in driving value. Businesses must manage their health care supply chain just as they do other supply chains to achieve more predictable costs and better outcomes.
3. Get engaged in the transformation process: Transformative change doesn’t happen unless job creators have a seat at the table. As the true payers of health care, be it through premiums, self-insuring or state and federal taxes, businesses have the power to improve value and propel the transformation process. Employers bring a unique perspective to the table because their interests include employee productivity and safety outcomes. These interests need to be understood by supply chain stakeholders.
Help Us Improve Health and Health Care Value
In November, the NC Chamber Foundation named Kelly L. Fuller its new president. An experienced public policy expert in a host of fields, Fuller will lead the Foundation’s long-term policy development and strategic initiative activities to achieve the goals set in North Carolina Vision 2030, including making North Carolina a top state for health care value.
In 2020, under Fuller’s leadership, the NC Chamber Foundation will advance its five-year strategic plan to catalyze employer engagement and encourage collaboration across the health care supply chain to further transformation. Stay tuned for more on our efforts.