Health Care Coalitions Can Effect System Change
Michael Thompson likes to hit the ground running. In his new role as president and CEO of the National Business Coalition on Health for just a few days, he’s already going full steam ahead with an ambitious agenda to tackle many of the challenges facing the health care industry.
He believes, for example, that the administration of occupational and nonoccupational injuries and illnesses should be integrated wherever possible to provide more effective care for patients.
Among his other goals are: fostering an independent system to evaluate returns-on-investment to identify truly effective health care strategies, helping employers generate employee engagement in their own health care decision-making, incorporating community resources into wellness campaigns, and creating a strong infrastructure on the topic of well-being.
“We really want to make sure the focus of NBCH is leveraging the collective efforts of the coalitions,” Thompson said. “This coalition infrastructure is an unbelievable opportunity to accelerate the change that we, as employers, or the country is looking for.”
The National Business Coalition on Health is a 24-year-old not-for-profit company consisting of 51 purchaser-led health care coalitions. Described as a “coalition of coalitions,” the organization “provides expertise, resources, and a voice to its member coalitions across the country and represents each community coalition at the national level,” according to its website.
Thompson, who was named to the top post after spending 20 years with PricewaterhouseCoopers LLP where he was a principal, says that by getting the coalitions to work in a coordinated manner, he hopes to make meaningful inroads in the delivery of health services and reform of the nation’s health care system.
Advancements in the medical delivery system are happening so rapidly it’s difficult for organizations to know what they are, let alone how effective each is. It’s an area where a coordinated effort can allow the coalitions to more easily reveal the strategies that are working best.
“One of the weaknesses in the system today is too often people will tell you what their ROI is, but it’s all self-reported based on their own analysis,” Thompson said. “We need a system that’s more accountable and leads to independent evaluation so we can share that and accelerate the success of those delivering results and cause others to look seriously about making improvements.”
“There’s a lot of movement underway to start to change the way we pay for and deliver and even the way we organize around health care and provide value based care.” — Michael Thompson, president and CEO, National Business Coalition on Health
Such a system would allow the coalitions to support those organizations and strategies that are most effective, and it would help people to become healthier. “What could be healthier to the system than a system that’s accountable?” Thompson said. “We need to develop accountability and improvement that will help us turn the corner in health care.”
Reform of the health care delivery system involves many players, including employers. One of the most pressing issues involved is the affordability of health care — or lack thereof.
“There’s a lot of movement underway to start to change the way we pay for and deliver and even the way we organize around health care and provide value based care,” Thompson said.
“It’s incumbent upon us to figure out how to get the multiple players on the same page. It won’t happen overnight, but you’re already seeing a lot of activity around bundle payments, accountable care organizations in both the public and private sectors. Coalitions become very important to engage stakeholders to rationalize that in the community and NBCH needs to keep that broader picture in mind and facilitate and support the development of that.”
Wellness and Integration
The idea of wellness is being challenged and criticized within the health care industry, Thompson says. He believes the coalitions can help by integrating them into local communities.
“Wellness and population health is a local issue, it’s not limited to the four walls of work,” Thompson said. “Many employers are in multiple communities. We must find a way to help them connect in the communities.”
Along with wellness, Thompson supports what he says is the emerging issue of well-being. Where wellness refers to encouraging people to develop better habits, well-being is a broader concept.
“Well-being is enabling people to be the best they can be so they can thrive in their lives and perform optimally in their chosen work,” Thompson explained. “Well-being is a much higher order conversation, and it doesn’t start and stop with a health risk assessment.”
It also does not necessarily start and stop within the U.S. but can involve any areas of the world. Companies that are global should focus on well-being and integrate it into their cultures, Thompson said.
He endorses the idea of integration overall, including occupational and nonoccupational injuries and illnesses.
“Good health is good health. Good safety is good safety. How do you separate where work ends and life starts? The two are very much intertwined,” Thompson said. “The laws around workers’ compensation are certainly siloed and the processes are siloed, but companies, when they step back, have to deal with the administrative arm on a silo basis but more holistically if they are looking to enhance wellness or health.”
One area that deserves a more holistic approach is mental health. Beyond providing care to people who have mental illnesses are issues related to the stigma associated with it. Increased access to mental health care could help improve employees’ overall health and cut costs for payers.
“What’s even more concerning is in many ways it’s getting worse because we are getting used to the idea that if people want [mental health] services they should go out of network … that’s not sustainable or legal,” Thompson said. “If we can create a system with a more holistic view on treating the whole person, everybody wins, including those paying the bills … it’s one of the areas I’d describe as low hanging fruit.”