Director, Marketing and Product Development
Jennifer Austin joined The Alliance in mid-2019, leading the team in managing marketing efforts, including brand strategy, paid advertising, publication relations, social media, and website development.
Before joining The Alliance, Jennifer worked at a number of companies in Chicago and Madison focusing on marketing and strategy development for hospitals and health systems, including Advocate Healthcare (now Advocate Aurora Health), Augusta University Health, and HCA Healthcare.
Jennifer has a master’s degree in Global Marketing, Communications and Advertising from Emerson College and a bachelor’s degree in Art and English from The University of Iowa.
The Alliance is a purchaser of health care services on behalf of our employers. That means that The Alliance is not a typical payer or insurance plan but understanding what health insurance plans are doing is essential to continuing to learn and grow to help our employer-members. Attending the AHIP (America's Health Insurance Plans) Consumer Experience and Digital Health Forum involved a lot of discussion around transparency, benefit plan design, and payment reform – what we consider to be the core drivers that employers can use influence in high-value health care. And most exciting of all, one of AHIP’s panelists, Martin Makary, MD, MPH, said the very thing we know to be true. Employers may be the biggest driver in creating change within health care.
Data was a major theme at the conference. Not just for consumers, who want access to their own health data, but also for doctors and employers to have greater access to claims data. Farzad Mostashari, MD, ScM talked about how claims data could help predict patient outcomes by analyzing medical errors and oversights. He suggested that there isn’t greater availability to this data because people are okay with the status quo, quoting Upton Sinclair. “It is difficult to get a man to understand something when his salary depends upon his not understanding it.” Salaries depend on keeping data hidden, so it remains unavailable to those that might benefit from it most.
Dr. Mostashari believes, in the end, that all the worries about price transparency will have the same outcome as the transparency around clinical data. “It will be fine.” Every other industry that has gotten more transparency has seen more innovation, so he thinks it will improve health care.
In addition to the transparency around cost related to health systems, there was also a session about the role physicians play in health care transparency. Martin Makary, MD, MPH, presumes that there needs to be greater availability of quality data with measures beyond just complications. He has been focusing on the appropriateness of care and billing quality. Both Dr. Makary and Reed V. Tuckson, MS, FACP agreed that there should be a standardization of quality measures, so doctors are measured similarly and know the expectations.
They also talked about how doctors can help change patient behavior. “Access to data is not enough. Data alone doesn’t change behavior,” Dr. Tuckson said. He feels that physicians need to understand people’s decision-making and beliefs about health better. He wants to work with health plans to get data on how to be more consumer-centric. This topic isn’t covered in medical school, and Dr. Tuckson said there needs to be medical education around how to change people’s behaviors.
Dr. Makary also believes employers have the biggest ability to drive high-value care through steerage and by owning independent primary care clinics. He mentioned large employers, like Walmart, and I chimed in that we have small employers doing that great work as well. And that those are just two strategies The Alliance is working with employers to implement to drive high-value health care.
For more information on the strategies that our employers have implemented around high-value health care, and tips for self-funding, read The Alliance case studies. To learn more about how The Alliance works with employers to make health care more affordable, contact our Business Development team. Members and their advisors who want to learn more about our four core drivers are encouraged to contact the Member Service Team.
More About How Employers Can Change Health Care
Learn how you can influence health policy with The Alliance
Wisconsin Can Save $394 Million by Steering Patients to High-Value Health Care
Read case studies about employer-members who made a difference with self-funding
One of the best things about being part of an employer cooperative is watching employers learn from and with each other. Attending the National Alliance 2019 Annual Forum took that to the next level by gathering health care purchasing coalitions together to discuss new ideas and share best practices. The National Alliance 2019 Annual Forum, held November 11 – 13 in Washington, D.C., hosted about 40 health care purchasing coalitions from across the country, along with a number of vendors and partners.
The Fight For Transparency
The biggest takeaway from the forum is that most coalitions have the same focus that The Alliance does. The four core drivers – transparency, payment reform, benefit plan design, and provider network design – were discussed throughout the three-day event. The RAND Study, in particular, was presented as a helpful tool in the fight for transparency. The coalitions that have price information around how much hospitals are paid relative to Medicare are taking it to the negotiation table to get more affordable health care. The negotiations are not just for the employers, but for their employees too since households in the bottom 20 percent of income spent 26.8 percent of their income on health care in 2016, according to Health Affairs.
Payment Reform That Fits The Bill
Payment reform was also a hot topic discussed, in particular, surprise billing. The Economic Alliance of Michigan discussed surprise billing legislation that would limit out-of-network care providers from collecting only 125 percent of what Medicare pays for care in Michigan. Hospital associations are in support of a fix for surprise billing but do not want to agree to 125 percent of Medicare, according to one article. While this is being discussed at the federal level, individual states are trying to pass legislation until a federal law can be passed to resolve the issue.
One session, which included speaker A. Mark Fendrick, MD and Director of the University of Michigan Center for Value-Based Insurance Design, explored benefit plan design to eliminate low-value care and incentivize high-value care. Frendrick said that the employer sector is the right one to figure out health care because they’ve figured to spend money more efficiently in every other area. He believes that patients should have little to no out-of-pocket cost for high-value health care. Fendrick and a multi-stakeholder task force identified overused services that could be reduced with little to no harm to patients. Those services included vitamin D screenings, PSA screenings in men 70+, diagnostic testing and imaging before low-risk surgery, and exchanging branded drugs for generic drugs when they are available. When looking at those services, The Washington Health Alliance used the Health Waste Calculator to identify over $92 million in unnecessary pre-op testing alone that could be eliminated based on the recommendations. The conclusion being that increased cost-sharing on low-value services reduces health care spend and allows for increased spend on high-value services.
Network Design Based On Value
Provider network design was also a highlight of the event as General Motors’ Sheila Savageau, U.S. health care leader for global compensation and benefits, spoke about their unique partnership with Henry Ford Health Systems. They created a narrow network with concierge services. In doing this, they have reduced employee health care costs and improved service. The integrated health care delivery system shares cost savings and pays based on value. Henry Ford needs to hit a financial budget and will be held accountable for hitting essential quality, cost, and utilization of services metrics agreed upon with General Motors. Savageau ended her session by saying, “Employers need each other to really make a difference [in health care].” And The Alliance couldn’t agree more.
To learn more about how The Alliance works with employers to make health care more affordable, contact our Business Development team. Members and their advisors who want to learn more about our four core drivers are encouraged to contact the Member Service Team. And to learn more about why our member, Brakebush Brothers, Inc., won the 2019 Employer/Purchaser Excellence Award by the National Alliance of Healthcare Purchaser Coalitions alongside The Walt Disney Company this year read the case study on how they had lower per member health benefit costs in 2018 than in 2014.
Learn about The Alliance Roadmap to High Value Care: Provider Network Design, Payment Reform and Transparency
Read the case study on our member, Brakebush Brothers
Visit the National Alliance of Healthcare Purchaser Coalitions website