Health Transformation Awards
In 2015, The Alliance Board of Directors established the Health Transformation Awards program to recognize people and/or organizations that demonstrate alignment with The Alliance mission of moving health care forward by controlling costs, improving quality and engaging individuals in their health. The awards are given out at The Alliance’s Annual Seminar every year in May.
Specifically, award recipients must demonstrate their commitment to promoting effective change in the health care marketplace based on one or more of the following criteria:
- High-Value Health Care: Is taking action to significantly improve the quality and/or affordability of health care
- Transparency: Is achieving significant gains in the availability and/or use of meaningful information to compare price and quality
- Payment Reform: Is developing, testing or implementing value-based payment approaches to encourage high-quality, affordable care
- Provider Network Design: Is developing, testing or implementing approaches to make high-value health care providers easily accessible to employees
- Benefit Plan Design: Is developing, testing or implementing approaches to support the appropriate use of high-value providers and treatments by consumers
Do you know someone who is moving health care forward?
You can nominate a person or organization for a Health Transformation Award here.
Health Transformation Award Winners 2019
Four awards were given to individuals or organizations that have made significant contributions to transforming health care in their community when The Alliance held its Annual Seminar on May 21, 2019.
NOVO Health is transforming the way health care is delivered and reimbursed. Their direct contracting model offers employer-partners transparent, bundled pricing on over 60 outpatient medical procedures.
Published, bundled pricing is a hallmark of NOVO Health. This enables employers and consumers to know, in advance, what the cost will be and to compare prices with other providers. Additionally, NOVO Health supports independent physicians, enabling them to compete successfully in an industry that is undergoing rapid consolidation.
NOVO Health’s systematic, process-oriented approach to delivering care has transformed the health care experience from expensive, fragmented and difficult to access, to caring, coordinated, affordable, accessible and transparent. Their model encourages employee engagement which educates and empowers consumers to make better decisions about their own health and the care they receive.
Based on NOVO Health’s analysis, they have saved self-insured companies an average of 30 percent on specialist services. Injured employees return to work an average of 20 days faster.
NOVO Health is being recognized for multiple reasons that include exploring new approaches to delivering and paying for care as well as improving the quality of care using a systematic, process-oriented approach that can be adapted by other organizations. They are also recognized for collaborating with other organizations to develop innovative solutions to significant health care problems and advancing our understanding of how to engage consumers in making better decisions about their care.
Promega Corporation is an innovator in designing and implementing a Caregiver Leave policy as part of their employee health benefits.
Caregiver Leave can apply to parents of newborns or older children, a spouse or partner, or aging parents. While the person being cared for is often the focus of attention, there is growing realization that caregivers also need support. The scope of employee need was not well known, so rolling out this benefit required a leap of faith.
On Jan. 1, 2018, Promega implemented Caregiver Leave benefits that include paid time off for employees providing supportive care to an immediate family member with a serious medical condition. Full-time or part-time regular, U.S.-based Promega employees are eligible for up to two weeks of paid time off over a designated 12-month rolling period for ongoing situations.
In the first year, 120 employees, or 12 percent of those eligible, utilized Caregiver Leave time. Time off requests varied from a few hours to more than 80 hours. A slight majority of those using the benefit were caring for an aging or seriously ill parent. Other common benefit uses were bonding with a newborn or caring for a seriously ill child or spouse.
Promega continues to expand its Caregiver Leave resources based on insights gained from the program’s first year. In 2019, the company added social service resources, bereavement and grief assistance, onsite workplace counseling services, aid with connecting to organizations that specialize in aging and disabilities, peer-to-peer support networks for caregivers and a “Circle of Caring” network initiated by fellow employees.
Promega is being recognized for providing extraordinary leadership among employers related to health benefits, specifically by representing employers’ interests and/or developing a consensus on important issues among a significant number of employers.
Marilyn Bartlett and the Montana State Employee Health Plan
Marilyn Bartlett is responsible for turning around the Montana State Employee Health Plan by drastically improving financial performance with no reduction in benefits or increase in costs to plan participants.
After an initial evaluation of the prices paid to doctors and hospitals, Bartlett’s investigation revealed dramatic and inexplicable variation in health care charges. The data showed that the Montana State Employee Health Plan was paying far more than the rates paid by Medicare – in some cases up to six times more than Medicare.
Bartlett used Medicare rates to benchmark and reset hospital payments to pay a fair price for health care – estimated at 220 to 250 percent of what Medicare pays. Getting hospitals to accept this reduction in fees took determination plus a willingness to withstand conflict at all levels. Resolving to exclude hospitals that refused to accept the new rates made the difference in the end, but taking this position created significant tension.
Additional strategies were added to complement the state’s referenced-based contracting model. These included:
- Moving to a transparent, pass-through pharmacy benefit, saving $7.4 million in just the first year.
- Changing the retiree prescription benefit vendor to allow access to CMS reinsurance and larger pharmacy discounts, saving $2.8 million the first year.
- Terminating wellness vendor contracts that were redundant, saving $5.5 million annually.
- Negotiating an 18 percent reduction in onsite clinic administrative fees.
- Refocusing staff on managing vendor contracts instead of delivering services themselves, resulting in a 23 percent reduction in FTEs.
- Implementing an online benefit enrollment and administration system for increased efficiency, saving $1.5 million the first year.
- Refocusing onsite clinics to provide primary care and act as a gateway to other health care services. Clinic staff bonuses are now based on health outcomes.
- Designing and implementing a medication therapy management program in partnership with the Montana Independent Pharmacists and the University of Montana Pharmacy School.
In 2014, the state’s benefit plan was projected to be $9 million in the hole by December 2017. With the changes spearheaded by Bartlett, this grim forecast did not become a reality. By December 2017, the state’s benefit plan reserves generated a surplus of $112 million. Some of these funds were used to provide enhanced benefits for enrollees. In addition, $25.4 million was repurposed as funding for the future state budget.
Bartlett and the Montana State Employee Health Plan are being recognized for exploring new approaches to paying for care. They are also advancing our understanding of how to engage consumers in making better decisions about their care.
- Gundersen Health System
- John Nygren, Wisconsin State Representative
- Open Notes, Catherine DesRoches
- Miniature Precision Components
- Wisconsin Collaborative for Healthcare Quality (WCHQ)
- Beaver Dam Community Hospital
- The Leapfrog Group
- Natasha Plank-Ottum, CEO of Plank Enterprises
- Valerie Shields, Stoughton, Wis.
- Webcrafters Inc.
- Dianne Kiehl, “Driver of Meaningful Change”, Executive Director, The Business Health Care Group
- QualityPath Designated Hospitals and Doctors
- Dr. Thomas Lewandowski
- Dr. Anthony DeFranco
- Dr. Tim Bartholow