NBCH Recognizes Plans for Engaging Members in their Health

Anthem Blue Cross and Blue Shield, BlueCross BlueShield of Tennessee, and Health Net receive 2014 eValue8™ Innovations Awards

WASHINGTON – November 21, 2014 – The National Business Coalition on Health (NBCH), a non-profit organization of purchaser-led business and health coalitions, honored Anthem Blue Cross and Blue Shield, BlueCross BlueShield of Tennessee, and Health Net with the 2014 eValue8™ Innovations Awards at its annual conference. The awards recognize the innovative work of plans to develop programs that engage members in managing their own health.

“A healthy and productive workforce is critical to the success of U.S. businesses competing in a global economy and we’re proud to recognize the innovations implemented by these plans,” said Foong-Khwan Siew, director of eValue8 for NBCH. “Motivating and empowering consumers to be active participants in their health and health care is a key component to a healthy and productive workforce, and the eValue8 award winners and finalists are excellent examples of leaders working to improve member health.”

Forty Percent of Payment to Physicians and Hospitals in the Commercial Sector Today is Designed to Improve Quality and Reduce Waste

Catalyst for Payment Reform (CPR) today released the 2014 National Scorecard on Payment Reform. The 2014 version of this annual Scorecard indicates commercial health plans have dramatically shifted how they pay physicians and hospitals, with 40 percent of their payment now designed to encourage health care providers to deliver higher-quality and, in some cases, more affordable care.

The National Scorecard on Payment Reform uses data submitted by commercial health plans on a voluntary, self-reported basis to eValue8, the National Business Coalition on Health’s annual request for information to health plans. The plans responding to the Scorecard questions represent 65 percent of the commercially-insured lives in the U.S.

You can read more about the 2014 Scorecard here and access the complete Scorecard online.

NBCH Names Top Performing Health Plans According to 2014 eValue8 Results

Annual health plan survey and evaluation encourages transparency and accountability,
promotes quality improvement

WASHINGTON – September 16, 2014 – Kaiser Permanente Colorado was named the top performing health plan according to the 2014 eValue8 results released by the non-profit National Business Coalition on Health (NBCH). A critical element of purchasers’ value-based purchasing strategy, eValue8 is an annual health care accountability and quality improvement assessment used by employers and coalitions to manage the quality and efficiency of America’s health plans.

“We’ve incorporated eValue8 and the results into our RFI and procurement process,” said Kerry Schaefer, manager, Compensation & Benefits, for King County in Washington. “Plans can’t do well on an eValue8 survey unless they are putting a heavy emphasis on value-based benefit design.”

2014 benchmark plans
Plans who achieved the best performance (benchmark) among all insurers responding for specific modules include:

• Physician and Hospital Management and Measurement – Aetna Washington
• Helping Members Stay Healthy – Kaiser Permanente Colorado
• Helping Members Become Good Consumers – Cigna CaliforniaHelping Members Manage Acute/Episodic Conditions – Cigna Connecticut and Group Health Cooperative
• Helping Members Manage Chronic Conditions – Kaiser Permanente Colorado
• Pharmaceutical Management – Kaiser Permanente Colorado
• Business Practices – Cigna California

Additional details on the 2014 results and other top ranking plans can be found on NBCH’s eValue8 website. Participating NBCH member coalitions included the Colorado Business Group on Health, Healthcare 21 Business Coalition, Memphis Business Group on Health, MidAtlantic Business Group on Health, Northeast Business Group on Health, Pacific Business Group on Health and the Washington Health Alliance.

According to the NBCH Value-based Purchasing Council, savvy plans understand that buying health care on price alone is only a quick fix. While it might save some money in the short-term, it is neither a sound nor sustainable strategy to bend the cost curve. Value-based purchasing can help shift the paradigm of why employers offer health benefits, from seeing it as a recruitment and retention tool, to an opportunity to improve population health, increase productivity, and ultimately the employers’ bottom line.

“eValue8 helps purchasers understand the value of their investment in providing health benefits,” said Foong-Khwan Siew, Director eValue8 for NBCH. “The program advances value-based purchasing by measuring and reporting on year-to-year plan accountability.”

2015 survey release
The 2015 eValue8 survey will be available for health plans to complete in November. NBCH encourages purchasers and their consultants to ask their plans to respond to eValue8 2015 to assess the value of their investment.

About eValue8
An annual health care purchasing and quality improvement assessment process, eValue8 was created by business coalitions and employers like Marriott and General Motors to measure and evaluate health plan performance. eValue8 asks health plans questions about how they manage critical processes that control costs, reduce and eliminate waste, ensure patient safety, close gaps in care and improve health and health care.

NBCH believes that local business coalitions are key in facilitating multi-stakeholder collaborations at the community level to educate consumers, and improve quality and efficiency of the health delivery system. Purchasers interested in having their plans report performance in a variety of health services can contact NBCH or their local business coalition.

About National Business Coalition on Health 
National Business Coalition on Health (NBCH) is a national nonprofit membership organization of purchaser-led health care coalitions, representing more than 4,000 employers and about 35 million employees and dependents. NBCH and its members are dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. NBCH seeks to accelerate the nation’s progress toward safe, efficient, high-quality health care and the improved health status of the American population.

NBCH’s 19th Annual Conference will be held November 10-12, 2014 in Washington. Additional details and registration information can be found here: http://www.nbch.org/2014-Annual-Conference.

New NBCH Action Brief on Community Health

According to the County Health Rankings, an annual breakdown of the health of counties in every state, there are a multitude of factors that influence health, including where people live, learn, work, and play. Improving the health of a community should be everyone’s business, and employers play a critical role in helping to build healthy communities and promote a healthy population. This Action Brief outlines the scope of community health; how health plans are addressing the issues based on data from eValue8™ — a resource used by purchasers to track health plan performance — and actions employers can take to partner with others and invest in the health of a community through sustainable and evidence-based interventions.

NBCH gratefully acknowledges the support of the American Public Health Association’s Community Transformation Grant Program funded through CDC grant #5U58DP003757-02, CDFA #93.531 for the development of this Action Brief.

Catalyst for Payment Reform Releases National Scorecard on Payment Reform

Catalyst for Payment Reform (CPR), an independent, non-profit employer coalition pushing for better value in health care, today released its first National Scorecard on Payment Reform. The Scorecard shows that only about 11 percent of the health care dollars we pay to doctors and hospitals today are value-oriented -- tied to how well they deliver care or create incentives for both improving quality and reducing waste. Almost 90 percent of payments reported remain in traditional fee-for-service, paying providers for every test and procedure they perform regardless of necessity or outcome, or in bundled, capitated, or partially-capitated payments without quality incentives.

Within the 11 percent of payment that is value-oriented, the Scorecard finds that 43 percent of those payments give providers financial incentives by offering a potential bonus or added payment to support higher quality care, such as fee-for-service with shared savings. The other 57 percent of payments put providers at financial risk for their performance if they do not meet certain quality and cost goals, such as bundled payment.

The National Scorecard on Payment Reform uses data submitted on a voluntary, self-reported basis to eValue8, the National Business Coalition on Health’s annual Request for Information to health plans. The plans responding to the Scorecard questions represent almost half of the commercially-insured lives in the U.S. While Scorecard findings are not wholly representative of health plans across the U.S., they offer a preliminary baseline against which to measure progress toward value-oriented payment in the commercial sector.

2012 eValue8 top performing plans and key findings released

To help health care purchasers assess and manage the quality and efficiency of America’s health plans, NBCH released the 2012 eValue8 top performing plans, key findings, and 2013 RFI.

A critical element of a purchasers’ value-based purchasing strategy, eValue8 is an annual health care accountability and quality improvement assessment process used by employers and coalitions to gather health care data from plans across the nation.

2012 Top Performing Plans 
Three plans garnered the top overall performing spots this year: Kaiser Permanente Southern California and Kaiser Permanente Northwest for HMO; and Cigna Pennsylvania for PPO. Plans who achieved the highest scores (benchmark) for specific modules include: Cigna in California, Colorado, New Jersey, Tennessee and Washington; and Tufts Health Plan Massachusetts for PPO; Kaiser Permanente in Southern and Northern California, Colorado, and Northwest; Group Health Cooperative in Washington; and Cigna Colorado for HMO.

2012 eValue8 Findings

The 2012 eValue8 process identified opportunities for all health plans to reduce waste, address gaps in care, structure payment reforms and improve consumer engagement. While plans have made progress in transparency of provider measurement, more needs to be done in the area of payment reform.

Additional information on the key findings and 2013 RFI can be found in today's news release.

Opportunity to Participate in a Discussion on California Health Insurance Exchange Design

On Wednesday, August 1, the California Health Benefits Exchange will hold a stakeholder webinar to discuss quality and affordability of Qualified Health Plans offered in its exchange. NBCH staff has been working with the California exchange to incorporate eValue8, where appropriate, and this webinar will include a discussion of the use of eValue8.    State exchanges are required to develop guidelines for how quality information is collected and reported, and eValue8 is an existing tool that states may consider using for this purpose.  NBCH has been working with other states as well, and supports standardization of quality information, and is willing to work with exchanges to create flexible platforms to store information in a dynamic way for plans to update and consumers to use.  NBCH is also willing to support enhancements and some tailoring of questions in eValue8, such as for the disparities section.  Members who have been involved in the eValue8 process, as well as those who are interested in learning more about either eValue8 or the state health insurance exchanges, are welcome to participate.  

NBCH is in the process of developing a member education strategy around health insurance exchanges, and this California opportunity is one of many ways in which we anticipate being involved in the development of exchanges.  If you would like to provide feedback or input on ways in which NBCH can be helpful as coalitions navigate policy issues related to exchanges, please let Colleen Bruce know.  

Catalyst for Payment Reform releases model contract for employers

The Catalyst for Payment Reform released a tool to unite employers and other health care purchasers around the shared goal to make 20% of health care payments based on value by 2020. This tool should help coalitions with their efforts to reform payment in their communities.

The model contract highlights immediate opportunities to reform how health plans pay doctors and hospitals. Together with CPR’s health plan RFI (request for information) questions on payment reform, which purchasers use for selecting health plans, the contract language outlines bold purchaser expectations for progress on payment reform by their contracted plans or third party administrators. Expectations include advancement toward: value-oriented payment; quality and price transparency; comprehensive consumer decision-support tools; and monitoring of the level of competition among providers.

The CPR RFI references eValue8. NBCH and CPR have been collaborating since 2010 to synchronize as much as possible the information being asked of plans around payment reform. Some of the questions in the CPR RFI were in eValue8 2011. Since then we have worked together and with an outside consultant to refine the questions; gathering feedback from the plans in August last year for inclusion in eValue8 2012.

Additional information from CPR can be found here.

Maryland Health Care Commission considers use of eValue8

As a result of the efforts of the MidAtlantic Business Group on Health, the Maryland Health Care Commission is considering requiring health insurance plans to report scores to eValue8 in 2013. This information is featured in the latest issue of the Washington Business Journal. The article can be found here.

Catalyst for Payment Reform provides purchasers with maternity care payment resources

Labor and delivery account for nearly a quarter of all hospitalizations for many employers, and costs associated with pregnancy and its complications are a driving factor in the rising costs of health care. Cesarean deliveries, elective labor inductions and scheduled deliveries before 39 weeks are also the rise. The growing use of medically unnecessary interventions is increasing costs and the incidence of complications among mothers and babies, with no evidence of improved outcomes.

There are a variety of payment alternatives that can align incentives for providers and hospitals to adhere to evidence-based practices that improve outcomes for both infants and mothers and decrease the growth in health care spending for maternity care services. CPR has put together an Action Brief for health care purchasers that provides both an overview of the payment reform opportunity and steps purchasers can take to begin implementation.

Dear eValue8 Users and NBCH Member Coalitions:

As you may know we've been working to revamp the eValue8 communications materials to provide updated information to be used in marketing eValue8. Pasted below please find the eValue8 Mission and 2017 Vision as well as the “About eValue8” statement that will be used on the website and as the boilerplate for all press-related materials. 

We are also in the process of finalizing additional materials that can be used as is or customized for your own market including an eValue8 fact sheet, teaser/sell sheet and a purchaser advantage one-pager. The media guidelines on the eValue8 website are also being updated.

Please let us know if you have any questions.

Regards,

Foong- Khwan Siew, Director of eValue8, NBCH (fsiew@nbch.org)

Dennis White, Senior Vice President of Value-Based Purchasing, NBCH (dwhite@nbch.org)


Mission: eValue8™ is a transformational resource to help NBCH member coalitions lead in improving health and value of health care services in their communities by advancing value-based purchasing.

2017 Vision: In 2017, eValue8 is the essential resource used by coalitions and purchasers to align purchaser-plan strategies that advance value-based purchasing.

About eValue8™
eValue8 was created by business coalitions and employers like Marriott and General Motors to measure and evaluate health plan performance. eValue8 asks health plans probing questions about how they manage critical processes that control costs, reduce and and eliminate waste, ensure patient safety, close gaps in care and improve health and health care.

Health plans provide detail on how they educate, engage and incent consumers to promote health and manage disease, as well as measure and pay providers. Plans and purchasers receive objective scores enabling comparison of plans against regional and national benchmarks and a roadmap for improvement. As a result of face-to-face discussion of findings and roadmap, plans learn what they need to do to align their strategies with purchaser expectations to maximize the value of the health care investment and ultimately, improve health and quality of care.

For more information on eValue8...

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