Aligning the Interests of Employer Purchasers and Physicians to Accelerate Value

Employers have a big influence on how and whether, as a nation, we accelerate the pace to value-based care. Employers also collectively shoulder the biggest share of national health care costs, which regularly rise faster on an annual basis than overall inflation. At the Council of Accountable Physician Practices (CAPP), we define and practice value-based care as care that is coordinated through teams, connected with health information technology, led by physicians, and paid based on quality and cost outcomes.

For these reasons, CAPP leaders embarked two years ago on a “Better Together Health” initiative to learn more about the challenges and opportunities employers face as they seek greater value from the local and regional health care delivery systems where their employees live and work.

The COVID-19 Pandemic Accelerated Opportunities for Employers and Physician Groups

Despite the demands placed on both physician groups and employers by the COVID-19 pandemic, leaders from both sectors came together during 2020 for three regional roundtables to discuss topics that became more salient during and pandemic, including:

  • integrating behavioral health care with primary care;
  • expanding telehealth through value-based care incentives; and
  • demanding more transparency from insurers and other intermediaries.

The 2020 roundtable discussions, published in a report titled “Aligning Interests: Opportunities for Purchasers and Physicians to Accelerate Care Delivery, Innovation & Value,” uncovered opportunities for further collaboration, particularly as both physician groups and employers evaluate results of new behavioral health models, define when telehealth services are most clinically appropriate, and sift through newly available data on cost and quality from various sources.

Through these very valuable discussions, we have identified common pain points like the need for care coordination, a seamless patient experience, and the importance of alternative payment systems to reduce fragmentation and strengthen incentives for high value care.” Stephen M. Parodi, MD CAPP co-chair

CAPP has collaborated with the National Alliance of Health Care Purchaser Coalitions to better understand employer purchasers because we recognize the power that employers can have to drive system improvement, if they work together. Health care is delivered in local and regional markets. The regional business coalitions that comprise the National Alliance support member employers on innovative purchasing strategies, evaluating benefit designs, and sorting through the explosion of vendors selling targeted approaches to improve employee health.

It’s rare for employers to communicate with physicians outside of intermediaries such as their consultants and health plans,” said Margaret Rehayem, National Alliance vice president

In 2019, CAPP embarked on listening sessions with diverse employers across five unique markets, and we heard employers’ growing frustration with the lack transparency around cost and quality, their inability to identify and eliminate wasteful and even harmful low-value care, and their caution in making changes to provider networks.

In 2021 CAPP will continue our ongoing employer purchaser initiative by discovering how the COVID-19 pandemic may be changing employer and employee health care needs and priorities.

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