Health Care Solutions: High Value, Low-Cost Strategies

May 09, 2014 - 8:45am

Last year, the U.S. Chamber of Commerce’s Health Care Solutions Council released a 55-page, four-part report outlining legislative and regulatory recommendations to improve the health care system. This year, the Chamber is holding a series of events to dive deeper into the report’s findings and recommendations, including achieving meaningful transparency. The second event in the four-part series is taking place on May 9, and will explore ways businesses are working to improve the health of their workers.

Countless studies by the Institute of Medicine have found that health care costs are much higher and outcomes much worse than they could be in part because of early onset of preventable chronic conditions, poor care coordination, and the underuse of high-value, low-cost services, providers, and treatments.

However, several pioneering employers and health care providers have instituted programs to improve employee health at lower costs. Wider adoption of such programs will avoid costly complications of chronic diseases and other preventable health problems, according to the report.

Health Care Solutions Council facilitator Mark McClellan, director of the Brookings Institution’s Engelberg Center for Health Care Reform, describes how employers are moving away from traditional approaches to health care:

Improving quality of care and shifting to a culture of promoting wellness rather than just trying to treat diseases and their complications is the best way to get to a high-value health care system. As many employers emphasize, this is a holistic approach to health, an approach that centers on what’s best for the person to stay well or get better. And that can mean support for fitness, support for healthier eating, support for many other things that aren’t traditional healthcare.

The Solutions Council report includes examples of employee health and wellness programs at companies including Dow, Boeing, Johnson & Johnson, and Marriott. Components of these wellness programs range from free annual physical exams and seasonal flu shots to smoking cessation programs and access to health coaches.

Many employers, in conjunction with insurance companies and provider groups, support the delivery of higher-value care to people with complications and chronic health problems. For example, UnitedHealth Group developed a program called HouseCalls that provides an in-home assessment for Medicare beneficiaries at risk of hospital readmissions. WellPoint employs specially trained physicians called “extensivists” to carefully monitor every aspect of their frailest members’ care. 

Consumer-focused financial incentives can also influence choice and drive individuals to seek care from providers who deliver better outcomes. Examples of these incentives include tiered plan designs to promote a specific network of select providers and hospitals and reduced out-of-pocket costs for completing a voluntary health assessment or complying with preventive care guidelines for chronic diseases.

Finally, health information technology (“health IT”) has tremendous potential for improving patient care and lowering health care costs. The convergence of medical advances, mobile medical applications and cloud-based electronic health records (“EHRs”) can transform the delivery of care by bringing the provider and patient together virtually, especially in disadvantaged areas.

The Solutions Council offers several recommendations, among them:

  • Promoting outcomes-based health care payments and benefits among private plans and Medicare. 
  • Moving toward outcomes-based regulation of employers, insurers, and providers.
  • Advancing the adoption of interoperable health IT systems nationwide to connect and expand access to health care anywhere and at any time.
  • Encouraging value-based insurance programs and consumer-driven health plans.

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Realizing Greater Value in Health Care: Building on Private Sector Successes

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