I was all set to write a post on the oral arguments being presented to the U.S. Supreme Court this week on the constitutionality of the mandate to purchase health insurance and other issues related to the Patient Protection and Affordable Care Act, otherwise known as healthcare reform. However, I will leave the discussion of the meaning of Justice Kennedy's questioning and which way Chief Justice Roberts is leaning to the experts. SCOTUSblog in particular is doing great work covering the case.
No matter how the Supreme Court rules, employers still must deal with the day-to-day management and costs of their employee health benefit plans. So, let's focus on something that employers can control: how well they manage and connect with their vendors as a way to improve quality of care and manage costs.
In a growing realization of the important role vendors can play in employer efforts to engage employees in healthcare decision making and to promote patient safety and quality improvement, more employers are consolidating these vendor relationships, according to the 2012 Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Healthcare. The survey includes responses from 512 employers.
The overall goal of this effort is to achieve greater end-to-end care management and improve active oversight. This can take the form of consolidating health plan vendors (30% have done so and 11% plan to do so next year) and consolidating existing health and productivity programs with the health plan (22% have done so and 15% plan to do so next year).
When it comes to vendor performance, there is room for improvement. For example, the survey found that employers want to rely on their vendors to drive the type of behavior change among employees necessary to spur more efficient use of the health care system and healthier lifestyles. Not surprisingly, lack of employee engagement in their healthcare usage and decision making continues to be an area of overall frustration for employers, so it is not necessarily surprising that this frustration should spill over into vendor relationships.
In addition, employers want their vendors to be more effective at leveraging data to determine appropriate treatment plans for chronic conditions, to identify gaps in care and to help make clinical decisions regarding preference-sensitive care. The good news is that, although these frustrations remain, employers' overall view of vendor performance in these areas has become more favorable. The gap has narrowed between employers who have a favorable view of vendor performance in these areas and those with an unfavorable view.
In the future, employers see promise in the power of price transparency, direct contracting with providers and more effective care management for both chronic and catastrophic as long-term ways to manage costs.
There is plenty of other good information in the full Towers Watson/NBGH report, including cost trends and the overall employer view of the long-term viability of employer-provided health benefits.