Last year I wrote about the Health Transformation Alliance (HTA).
HTA is a group of large employers that joined together in an effort to control
their health care insurance expenses by reducing the costs of services driving
premium increases. Last year, the Alliance had approximately 20 members. In a
year, the number of participants has doubled, representing more than six
million employees.
According to a New
York Times opinion column written by HTA’s chief executive, the organization’s member companies account
for nearly $25 billion in health care spending. It has projected savings of
$600 million by optimizing its spending on prescription drugs, only one of four
tools in the Alliance’s toolbox.
A second tool is its data and analytics solutions, provided
by IBM, a member company. HTA’s members aggregate their anonymized health care
utilization records, forming a huge data set it can analyze to identify and
prioritize the sources of waste and overspending most in need of
optimization.
Another tool is “medical solutions that modify and improve
the current provider delivery system.” While it sounds ambitious for employers
to try to overhaul the provider delivery system, it’s important to understand
that the health care system is already in the process of transformation.
Providers, payers and regulators are committed to improving outcomes, paying
for value, and enhancing the patient experience. HTA can help accelerate these
changes by guiding their six million employees toward insurance plans and health
care providers that meet these goals. At the same time, they may be able to
smooth the transition to risk-based reimbursement for providers that are
reluctant to leave the fee-for-service system by providing a large, stable
population of patients enrolled in a fee-for-value plan.
The fourth tool is “consumer engagement solutions.” While
HTA doesn’t fully describe the details of this solution on its website, one can
assume that engaged patients will have better clinical, social, and economic outcomes.
For example, engaged patients are more likely to take advantage of preventive
and wellness programs and adhere to chronic disease management regimens.
HTA’s approach is a free-market response to the
unsustainable growth rate of employers’ health care insurance costs. Although
they’re just getting underway, they seem to have the right approach and the
right set of tools to make a first, significant impact on health care costs.
There is a temptation to contrast HTA’s success against the
federal government’s recent failure to pass a health care reform bill, but in a way,
that misses the point .
Each initiative is aimed at a different part of the health care landscape. The
government is grappling with how to provide insurance coverage through
Medicare, Medicaid and individual policies at a reasonable cost to as many
Americans as possible and can’t move forward with other parts of health care
reform because of bureaucracy. The tools at their disposal are policy, the tax
code, and funding. Employers aren’t tied to the reconciliation process and can
focus on quickly solving health care issues that incur the most cost and impact
care. They are using high tech and economies of scale to drive down the
underlying costs through economies of scale. Tackling both aspects of
healthcare reform is important, but at the moment only the latter is succeeding
because of collaboration in working toward common goals.
