Dr Suzanne Delbanco: Employers Have a History of Pushing for Healthcare Transformation

Since they foot the bill for a lot of Americans’ healthcare costs, employers have a lot vested in the health of their populations and have been involved with pushing for healthcare transformation, said Suzanne Delbanco, PhD, MPH, executive director of Catalyst for Payment Reform.

How are employers getting involved in the movement to value-based care? How have they been involved with healthcare transformation in the past?
Employers have a lot vested in the health of their populations, and even though it seems like they’re not a big player in the healthcare system, they actually foot the bill for a lot of Americans and benefit directly when their populations are healthy and productive and not distracted with dealing with the challenges of the healthcare system.

Employers have been involved with everything from pushing for standard ways to measure healthcare performance, public reporting on that performance, and now, tying payment to that performance, and even price and quality transparency writ large have been areas of interest to employers. So, they’re involved mostly through pushing their health plans to change the way that they are operating and the contracts that they have with providers.

But, also, some of them, especially the larger, more sophisticated ones have entered into direct contracts with providers and through those direct relationships have really been able to focus on quality, on efficient use of resources, and on getting more affordable care for their populations.

When employers look at new payment models and delivery models, is there anything that they think has the best potential?
I think employers want to see more bundled payment happen. The results have been, on the whole, promising, and there are some procedures and services that they buy over and over again for their population members that are unevenly prices and where there is uneven quality out in the market.

There have been examples of where, in working directly to providers and paying them with a bundled payment, employers have seen much more appropriate care delivered, where patients, who let’s say weren’t appropriate for having spine surgery, are now turned away by providers who have the right incentives to only focus on patients who need the care, and are paid in a way that enables them to do that.
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