Michelle DeNault, senior benefit analyst, Wawa, spoke on her organization’s membership with the Greater Philadelphia Business Coalition on Health (GPBCH), specifically how tools provided by the Coalition and the Leapfrog Group have improved hospital price transparency for employers and beneficiaries in seeking value-based care services.
Wawa was the first employer to join the Greater Philadelphia Business Coalition on Health (GPBCH) and our membership has provided guidance on advancing hospital price transparency and other value-based initiatives, especially during the pandemic, said Michelle DeNault, senior benefit analyst, Wawa.
GPBCH will be hosting a 10 year anniversary event on November 10, 2022.
Why did your organization join GPBCH?
Wawa joined to make a difference and change the status quo. I think once we realized that there were other coalitions out there in other areas and states that made a difference in the safety and the quality of health care, we thought it was pretty important that we make that move. Neil [Goldfarb, the CEO of GPBCH] took the first step, more like a leap, and Wawa was the first employer to take the next step and be the first employer that joined the coalition.
What specific Coalition initiatives are important to you?
Number one, for me, I would say is Leapfrog. We pay for those services as an employer and we're self-insured, so our associates use that, we pay for it. And once I learned more about Leapfrog through the Coalition, it became more apparent that we needed to get involved. Our associates are receiving care in hospitals that are not necessarily top notch, they don't have the best quality.
Leapfrog could help them get there. And why as employers would we want to pay for a procedure more than once and have our associates negatively impacted, not only loss of work, but then again, we're paying for it twice. So, all in all, all the way around, lack of quality and safety and care is just, it's not good. It's not good for us, it's not good for our associates or financially.
Number 2 would be the pricing difference that we have between what hospitals charge Medicare vs what they charge, say, our Aetna coverage or Wawa, or any of the other employers. It’s multiple times more for the employer than what they charge Medicare. And that's a huge gap, which needs to kind of come down a little bit. And that'll probably take some time. It took us quite some time to get. Originally, when we started with the hospitals, with Leapfrog, there were only 3 hospitals. I believe now we're up to 37, so it just takes time.
Why should other employers in the region join the Coalition?
Well, like I just said, with Leapfrog, we moved from 3 to 37 hospitals. Imagine if we had more employers and we had a bigger base. That means we would have a louder voice. And then maybe the Medicare pricing wouldn't take so long.
Also, we learn from each other. We share issues that we have, how we solve them. Unprecedentedly, nobody saw this pandemic coming and employers were scrambling, benefits departments [were saying], what do we do? How do we handle this? And we had meetings and as employers we just shared what we were doing, what we were facing, what seemed to be working, what wasn't working. It's also a great place to share that kind of info and help each other solve it.
As health care evolves, what future do you see coalitions having in advancing equitable health of employees and their beneficiaries?
What I would hope for is that the coalitions and the health care providers from the hospitals to medical groups work together to make sure that all people get the coverage, the safety, the quality, the care that they need and deserve, and maybe work together to get that out there.
I think initially, the Coalition kind of had to twist some arms to get them to go through Leapfrog, and I'm hoping that instead of twisting arms, just eventually work together and have a great outcome for all.