Revolutionizing Healthcare at the Community Level

In the relentless battle to curb escalating healthcare costs, it’s imperative that your clients recognize their power to revolutionize healthcare, enhance plan choices, and bolster affordability. However, achieving success and long-term sustainability in these endeavors hinges significantly on forging partnerships within the healthcare ecosystem. These collaborations encompass productive interactions with healthcare providers, health systems, health insurers, and like-minded employers who share a common vision. Here’s an insightful overview of the steps you can take.

The Allure of Strategic Alliances

Traditional health insurers often generate billions annually, leaving little incentive for them to reduce premiums for employers or negotiate favorable rates with value-based providers. Thus, it falls upon employers, who control the financial reins, to demand change. This entails fostering new kinds of collaborative efforts for collective solutions, including closer cooperation with healthcare providers and their associated health plans.

Proactive strategies formed around robust alliances can yield several advantages:

• Empower employers to negotiate directly or collaborate with their health plans to secure better per-unit costs while upholding provider accountability for improved outcomes and care quality.
• Enable healthcare providers to enhance clinical and data access, devoting more meaningful time to patient care.
• Grant patients improved access to comprehensive health services within an integrated system, reaping the benefits of seamless, coordinated care.
• Streamline the healthcare system, curbing fragmented, redundant care to lower costs and enhance overall outcomes.

Initiating Meaningful Connections

The goal of any skilled broker or advisor should be to guide clients in this transformative journey by first assessing what’s most crucial for their employees and their organization. Are cost-effectiveness or access to care pain points? Are there specific healthcare gaps that require attention? Are there particular services or solutions that could fulfill these needs? Here’s where the profound data transparency offered by a self-insured plan proves invaluable.

Next, acquaint yourself with top performing providers who share aligned incentives, such as a commitment to value-based care, backed by quantifiable metrics. How can you identify these providers? Data. Thus, it’s advisable to collaborate with a advisor utilizing the right benefits tech stack, who shares a common vision, and displaying the flexibility and innovative spirit that may be lacking with other “on-your-heels” advisors. The health plan should have insights into providers focused on value-based care and population health, ensuring they are held accountable for care quality.

Increasingly, healthcare providers are eager to collaborate more closely with employers, recognizing that “healthcare is local” and that reforming the system commences at the community level. To engage directly with a local provider, an effective initial step could be requesting education sessions for employees. These sessions, whether virtual or in-person, can cover critical topics like preventive health milestones or the significance of colon cancer screening.

The Business Rationale for Partnerships

When employers forge robust partnerships with those overseeing their healthcare plans and services, it’s a significant stride that offers substantial rewards:

• It’s a logical step: A healthcare system that aligns better with businesses promotes accessible, quality care where value surpasses volume. This ensures patients receive essential care before minor issues escalate into costly concerns.
• The broader perspective leads to cost reduction: In a coordinated system centered on population health, providers can oversee a person’s comprehensive care journey, unlike fragmented care within a disjointed healthcare system. This enables informed, timely care decisions and provides health plan sponsors with a potent tool for managing overall care costs.
• Price matters, but it’s not everything: A fruitful partnership is not solely about price considerations. While price is undoubtedly a critical factor, it’s also about directing care to the right places at the right times. For instance, a partnership that emphasizes early investment in quality primary care often translates to reduced spending on inefficient care, such as unnecessary inpatient admissions and ER visits.

The objective should be to strike a balance between cost and quality, frequently rooted in primary care and extending from there. Employees buy-in is essential, and effective communication is paramount to achieving this delicate equilibrium.