Monthly Archives: September 2011

Seven Insights to Help Connect with Employers

Friday, September 30th, 2011

Kriste Goad
Senior Vice President, Revive

There’s no doubt about it. The changing health care landscape, with its evolving models of care and payment, demands that hospitals and health systems build closer, more transparent, and more mutually beneficial relationships with the employers in their communities. For the first time in years, employers and providers are removing the middle man (the payor) and forming direct relationships in an effort to drive value.

It sounds simple enough. The leadership of hospitals and health systems most likely know many of the leaders of their local business community. Chances are they’re neighbors, friends, or even relatives. But when it comes to actually reaching out to the business community and engaging them in delivering value for their health care spend, there’s a disconnect. What health systems are beginning to realize, though, is that engaging employers is a vital part of the coordinated care equation.

Like any other piece of the coordinated care equation, building closer, more transparent, more mutually beneficial relationships with employers requires a plan. Once there’s a plan, it helps to know what to say and how to say it so employers know very clearly what it all means for them. It’s very much like delivering the right care in the right place at the right time.

Inevitably, though, when health care professionals talk, they use language and terminology that cause people’s eyes to glaze over. Seriously. Try it. Throw out phrases like “accountable care organization” or “patient-centered medical home” to someone in real estate or manufacturing and watch what happens. At the very least, they’ll probably think you’re talking about some sort of government program.

Yet employers outside of health care are being inundated with indecipherable information about health care from every source imaginable. We’ve talked to thousands of employers across the country about what’s going on in health care to find out what resonates, what moves the needle, and what annoys them. Here are the seven insights we’ve gleaned:

1. Lose the “mumbo jumbo.”

2. Quality is about people, and being treated like a person.

3. Demonstrate efficiency and coordinated care, and score big points.

4. Employers value wellness, and they want help from hospitals and physicians (not payors).

5. Transparency equals value, or at least the perception of it.

6. Tiered networks are just fine, thank you.

7. Choice and competition in health care are harder to understand than you think.

In the coming weeks, we will unpack each of these insights and outline the elements of a successful employer engagement effort. Like so many things in health care, building relationships and effectively communicating with employers is easier said than done. Call or email us (805.617.2832 or learnmore@revivepr.com) to learn more about our research findings and how we can help you make the connection with employers. And be sure to stay tuned…

Governors Can Wait and See, Health Care Providers Can’t (Part 2)

Thursday, September 1st, 2011

By Matthew Bassett

What should governors do when it comes to the exchanges? The recent WSJ article (Health Law Puts Governers in Pickle) highlights some important questions.

We would argue that Governor Perry has all the time in the world, especially considering that Texas is the only legislature that meets for no more than 140 nights every other year, and will not meet again until 2013. However, if Texas needs to act sooner, the Governor can always call a special session. Texas can move forward on exchanges (if it determines them to be in its best interests), but the real question should be “is the health care provider community ready for exchanges”?

From our experience in the marketplace and from virtually every piece of anecdotal evidence, the insurance community is more than ready. They are fresh off a victory, defeating the government-run public option in the bill, and becoming the only industry in American history in which citizens are mandated by law to purchase their product simply by virtue of the fact that they exist. And they are not resting on their laurels. AHIP and the individual payors are pressing forward.

A recent Price Waterhouse Coopers study (Change the channel: Health insurance exchanges expand choice and competition) polling insurers found that fully 47% of insurers have already completed or are halfway through mapping out their exchange strategies and 27% are more than halfway toward completion of the benefits and plans designs they will offer in 2014. Keep in mind that in 2014 the exchanges are forecast to generate $60 billion in premium dollars and the number is predicted to rise to $200 billion by 2019.

In our experience, the insurance industry is even more effective on the state level than it is on the national one when it comes to lobbying and shaping the legislative and regulatory environment. Payors are well positioned to advocate for their preference in state capitols as governors, regulators, and state legislatures weigh in on these key issues. Further complicating matters for the provider’s perspective, most insurance regulators have an insurance executive or broker background as opposed to health care.

How will providers respond? What strategy will we employ with key constituencies in states in which they operate, to their federal representatives, to the market place? How will they communicate their value to employers or government purchasers to justify exchange rates that allows their business models to continue?

Click here to read Part 1.