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Driving employees to high-value healthcare can improve quality of care while reducing costs for employees and their self-funded employers.

It’s no secret that we are facing some complex challenges in healthcare today. Over 70% of employers expect moderate to significant cost increases over the next three years. Around 100 million in the U.S. are struggling with medical debt causing 62% of bankruptcy filings each year. And there is a projected shortage of 17,800 – 48,000 primary care physicians by 2034.

To put it simply, healthcare is becoming more expensive and more difficult to access. That’s why at The Alliance, we’re working to move healthcare forward and improve the value of healthcare for employers and their employees. We serve as the voice for more than 300 self-funded employers across the Midwest who want to offer their employees better benefits for less money.

We drive high-value healthcare by contracting with high-value providers and empowering employers to educate their employees about the benefits of seeking care where the price is low, and the quality is high.

High-Value Healthcare Providers

We contract with providers who deliver high-quality care at low costs no matter where they fit into the healthcare ecosystem. We contract with independent and alternative providers and providers in larger health systems to create a broad provider network. To us, the type of provider doesn’t matter as much as the quality and cost of their services.

It is important for employers to have a robust network in their benefit plan design. The network must have accessible providers who can work together to offer an inclusive range of services. The Alliance partners with over 140 hospitals, 365 home health providers, 7,900 clinic sites, and 38,000 medical doctors and professional service providers to provide unparalleled access for self-funded plans in the state of Wisconsin. Our customizable Smarter NetworksSM include major health systems and alternative and independent primary care, behavioral health, and imaging providers. This allows patients to seek care where they are most comfortable and where they can get timely, quality care at a reasonable cost.

Independent Providers

In addition to traditional providers, The Alliance partners with providers who provide care independently outside of a major hospital or health system. Independent providers have the flexibility to schedule their own appointments, which allows them to spend quality time with each of their patients. This can lead to better patient experience and improved outcomes as patients feel comfortable, informed, and encouraged to take an active role in their health.

Alternative Providers

Telehealth services, including virtual primary care and behavioral health services, can offer more convenience. Patients can enjoy increased access to care with flexible appointment hours and, in some cases, 24/7 patient support and care navigation.  Virtual health companies are offering innovative, cost-effective solutions for patients.  

Health Systems

Providers who work in a health system can leverage their large-scale resources to provide specialized care for patients. Health systems in our Smarter NetworksSM include, but are not limited to:

  • Ascension Wisconsin
  • Aspirus Clinics
  • Dean/SSM Health/St. Mary’s
  • Gundersen Health System
  • Marshfield Clinic/MCHA Hospital
  • ProHealth Care
  • UnityPoint Health–Meriter
  • University of Wisconsin Hospitals

Employee Education

An effective network with high-value providers only goes so far if employees do not utilize these providers. Currently, 64% of patients do not research prices for healthcare services. So, it is important for employers to educate their employees on the benefits of seeking care where quality is good, and the cost is low. This not only helps keep costs down for the employee, making it easier financially to access care, it also keeps costs down for their self-funded employer meaning they can invest dollars that would have been spent on healthcare back into their employees and business.

Employees aren’t healthcare consumers until they need care, so making sure they know where and how to find their benefit information when they need it is essential. Employers can educate their employees on the importance and value of their benefits by communicating regularly and in multiple ways. Employers should consider:

  • Sending short, engaging newsletters to employees at consistent intervals.
  • Creating, or updating an employee resource hub where employees can access educational material and important information about their benefits.
  • Having a Q&A session with a subject matter expert within the organization where employees can ask questions confidentially.

Working Together Toward High-Value Healthcare

The Alliance does not accept the status quo; we’re continuously working to move healthcare forward. Behind the strength of our cooperative’s membership, we’re changing how healthcare is bought and delivered by contracting with high-value providers and empowering employers to drive their employees to high-value healthcare.

By working together, we can achieve the best results for all stakeholders in the healthcare industry. When employees utilize high-value healthcare, they can receive customized, affordable care and experience improved health outcomes. And their self-funded employers can lower their healthcare spend and reinvest their savings in their employees by providing improved benefits.

Tags:

Benefit Plan Design Better Health Care Consumer High-Value Healthcare Provider Network Design

Categories:

Members & Employers

Tags:

Benefit Plan Design Better Health Care Consumer High-Value Healthcare Provider Network Design

Categories:

Members & Employers
Cheryl DeMars

Cheryl DeMars
President & CEO, The Alliance

Cheryl DeMars joined The Alliance in 1992, assuming several roles before becoming CEO in December 2006. Cheryl works with the Board of Directors and senior leadership team to establish the strategic direction of the cooperative. Cheryl participates in a number of national and regional initiatives that align with The Alliance’s mission of controlling costs, improving quality and engaging individuals in their health. She serves on the Advisory Board of the Wisconsin Population Health Institute and the board of the Wisconsin Collaborative for Healthcare Quality. Prior to joining The Alliance, Cheryl was a program manager at Meriter Hospital in Madison. She earned a master’s degree in social work from the University of Wisconsin-Madison.

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