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In the fall 2019 round of The Hospital Safety Grade, the percentage of Memphis hospitals with an "A" (40%) continued to surpass the national average (33%)! And, the percentage of Memphis hospitals with an "A" and "B" (60%) also surpassed the national average (58%). Just two years ago, only 10% of Memphis area hospitals received an "A" and only 20% received an "A" and "B".
"We are pleased to see this continued momentum in the improvement of Memphis area hospital's Hospital Safety Grades. Sustained improvement over time results in fewer preventable medical mistakes, less patient and family suffering, and even lower costs," said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health (MBGH). MBGH is the Leapfrog Regional Leader for eastern Arkansas, west Tennessee, and north Mississippi.
In the greater Memphis area, 10 hospitals were graded, and four (4) earned an "A," two (2) earned a "B," five (5) earned a "C." No Memphis hospitals earned a "D" or an "F." Methodist Le Bonheur Germantown, Methodist University Hospital, Saint Francis Hospital – Bartlett, and Saint Francis - Memphis received an "A". Methodist North Hospital and Methodist South Hospital each received a "B". Methodist University, Methodist South, and Regional One increased their grades from the spring 2019 release. Methodist Olive Branch did not have sufficient information to receive a grade.
For detailed results on all Memphis hospitals click here.
The fall 2019 Hospital Safety Grade release coincides with the 20th anniversary of the Institute of Medicine's To Err is Human report which focused the nation's attention on the nearly 100,000 deaths a year due to preventable medical mistakes. A recent analysis from The Johns Hopkins Armstong Institute for Patient Safety and Quality found that 45,000 fewer deaths occurred in 2018 compared to 2015, based on the prevalence of safety problems in hospitals receiving a Leapfrog Hospital Safety Grade.
"The findings of the IOM report, published two decades ago, laid the foundation of what The Leapfrog Group stands for today," said Leah Binder, CEO of The Leapfrog Group. "We commend others who have joined us in the drive for transparency, including the Centers for Medicaid & Medicare Services, which commits to public reporting of safety data, employers and payors, who put appropriate pressure on facilities to make performance data available, and hospitals that publicly report on their safety and quality."
Click here to access safety grades for over 2,600 hospitals nationwide.
Here is a tool kit for employers to use as you evaluate the impact of hospital safety on your health benefit plans and your employees and their families. This toolkit also includes communication material you can share with your employees so they can get the safest care possible.
A meta-analysis of 54 peer-reviewed publications, government reports, and the "gray literature" estimates that 25% of total healthcare spending can be classified as waste ( Shrank WH, Rogstad TL, Parekh N. Waste in the US Health Care System: Estimated Costs and Potential for Savings. JAMA. Published online October 07, 2019. doi:10.1001/jama.2019.13978; accessed 10/10/19).
This publication advances our understanding of where this waste is actually occurring, potential savings, and even actions that can be taken to reduce waste.
The following charts use the highest estimates of waste and potential savings (estimated at a conservative 25% of waste) to help us target waste-reducing actions that are both impactful and practical. Note, the literature did not estimate potential savings for administrative complexity.
The interventions with the highest potential savings most applicable to employer actions include:
What can you do?
MBGH can assist our employer purchaser members understand more of the applicable findings of this publication and in these steps. We will also explore best practices and share current approaches to these high priority interventions with each other in our Health Benefits Peer Roundtable and Health & WellBeing Peer Roundtable. Reach out to firstname.lastname@example.com for more information.
Questions abound as health benefits managers rise to meet the challenges of changing health landscape, so we sat down with Joseph McCool, Principal of The McCool Group and moderator of the Employer Panel at Validation Institute's Memphis Health Care Benefits Summit, to talk through some of the hot-button topics we've heard from employers while out on the road.
Healthcare management is rapidly expanding, putting new tools in the hands of both HR professionals and employees. "At an enterprise level," Mr. McCool explained, "it means instituting controls such as pre-authorization for medical procedures. At the individual employee level, it means offering biometrics services to help individuals understand their current risk factors for disease and illness."
Awareness of these risk factors is only the first step, however. To reduce costs over time, individuals need to work with outcome-driven primary care physicians, and employers need to ensure that employees have access to those quality health care providers under their health plan.
According to Mr. McCool, transparency with employees is key: "You may not satisfy everyone, but you have to make a concerted effort to communicate why changes in healthcare coverage are needed and draw the line on change initiatives that would fundamentally alter the broader employer-employee relationship." You can't control what your company can afford, but you can control the way you explain it to those most affected, and do your best to ensure employees feel heard and appreciated.
While benefits brokers, as Mr. McCool explains, can do much of the heavy lifting to piece together multiple options to manage spend and expand offerings that makes sense, working with local and national organizations like the Memphis Business Coalition on Health, rounds out your decision-making. These organizations are great sources for networking and also provide an opportunity to share ideas and lessons learned. Most importantly, they're focused on helping its members take the flood of knowledge they receive from meetings, news articles, and other advisors and channel it all into meaningful, actionable steps.
Conversations about usage, preventive care, and outlining the benefits of the various services you offer, like telemedicine, are highly valuable but often overlooked. "If employees who don't regularly go for physical exams continue using the local Emergency Room as a catch-all for every health issue, those costs will really stack up on the employer," Mr. McCool advises. "Putting highly individualized health information into the hands of employees is a first-step toward managing costs and convincing employees that healthcare cost management can help preserve their jobs and the future of the company that employs them."
The stress of benefits administration can be significantly reduced by understanding the resources available to you, finding trusted partners and colleagues to help guide you through the process, and empowering employees to take their healthcare by the reins to be an essential part of the solution.
To learn more about these topics, sign up for Validation Institute's upcoming Memphis Health Care Benefits Summit. MBGH members, CEO Culture of Health participants, and Annual Supporters should contact email@example.com for the special registration link to receive your discount.
In this round of The Hospital Safety Grade, the percentage of Memphis hospitals with an "A" and "B" increased from 46% to 55%. Last year at this time only 20% of Memphis hospitals had an "A" and "B". Memphis now surpasses the national average (32%) with 36% of our hospitals receiving an "A".
In the greater Memphis area, 11 hospitals were graded, and four (4) earned an "A," two (2) earned a "B," four (4) earned a "C," and one (1) earned a "D". No Memphis hospitals earned an "F." Methodist Le Bonheur Germantown, Methodist Olive Branch Hospital, Saint Francis Hospital – Bartlett, and Saint Francis - Memphis received an "A". Methodist North Hospital and Methodist University Hospital each received a "B".
"With 36% of our hospitals receiving an "A", Memphis is now above the national average of 32% and we are much closer to the national benchmark of 58% of the hospitals receiving an "A" or a "B". Clearly this is good news! We are seeing some movement of hospitals between grades, but this type of movement has occurred in the past before grades became more predictable and sustainable. Safety is not a one-and-done; it results from a culture that insists on safety every day for every patient. MBGH looks forward to seeing these improved grades sustained over time. We will then be confident that the improvements are foundational and long lasting." said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health, the Regional Leader for The Leapfrog Group for the Memphis-area, and Vice Chair of The Leapfrog Group Board of Directors.
Alongside its semiannual Leapfrog Hospital Safety Grade update, Leapfrog contracted with The Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine to update its estimate of deaths due to errors, accidents injuries and infections at "A", "B", "C", "D" and "F" hospitals. Researchers assessed more than 2,600 hospitals receiving Hospital Safety Grades and found that when compared to "A" hospitals patients at "D" and "F" hospitals face almost double (92% greater) risk of death. This reseach shows that compared to an "A" hospital your risk of dying increases 34.9% in a "B" hospital; 87.7% in a "C" hospital; and 91.8% in a "D" and "F" hospital (combined. If every hospital had the performance of an "A" hospital, an estimated 50,000 lives saved could be saved. Overall, the researchers concluded that an estimated 160,000 lives are lost annually due to avoidable medical errors that are accounted for in the Leapfrog Hospital Safety Grade. See the report and infographic here.
These results reinforce the urgency in Memphis area hospitals continuing to improve the safety of care they provide. Memphians deserve to have the safest hospital care in the country. It seems we are on the right track, but still have work to do. Memphis Business Group on Health is committed to working together with our hospitals to achieve this as quickly as possible.
Over 80 stakeholders participated in MBGH's April 24, 2019 session designed to explore the components of a comprehensive worksite mental health strategy. Moving from component to component in small groups gave attendees a chance to share and learn from each other and think strategically about how to design benefits and well-being programs to support emotional health.
Take these steps to implement a comprehensive mental health strategy and consider adopting actions shared by other Memphis-area employers at our session!
(1) Know the Impact: Use wellness champions to understand personal impact on employees; include questions on employee surveys; track reasons for EAP utilization; analyze health benefit claims (medical and pharmacy);
(2) Break the Silence: Hold lunch-n-learns and seminars; provide management training; offer mindfulness/resilience programs; coordinate with HR policies/procedures
(3) Provide Access to Affordable, High-Value Care: Offer some provider visits at no cost; provide tele-behavioral health; coordinate vendors for cross-referrals; communicate frequently the resources that are available
(4) Build a Culture of Well-being: Use the term "emotional health" vs "mental health"; elevate recognition and status of wellness champions and councils; provide health coaches; coordinate with community organizations
Since May is Mental Health Awareness Month, what better time than this to evaluate your mental health strategy to be sure you are addressing all four of these components!
Check out mental health resources to help you implement a strategy on MBGH's blog here.
The spend picture for inpatient mental health and substance use looks different. Spend is being driven by both an increase in utilization and an increase in price.
Inpatient substance use increased utilization (18%) combined with significant prices increases (39%) increased spending per person by 64%! Inpatient mental health utilization remained relatively stable until 2017 when it increased 6%. A 14% increase in prices resulted in a 20% increase in spend.
MBGH's evaluation of the Addiction Recovery Medical Home with an alternative payment model, is designed to address rising spend that is very often not even accompanied by sustained recovery. Email firstname.lastname@example.com to learn more about this initiative.
1) Understand that price is the major driver behind spend. The Health Care Cost Institute's 2017 Health Care Cost and Utilization Report found that the total cumulative change in price from 2013-2017 was a 17.1% increase while utilization remained relaitvely stable. Overall spend increased 16.7% for this same time period.
(2) Continue effective traditional approaches to control cost. Willis Towers Watson's 2018 23rd Annual Best Practices in Health Care Employer Survey found employers taking these steps:
You might think that the most effective way to decrease spend is to reduce the amount of care needed and used. But the industry has traditionally responded to utlization decreases with price increases resulting in keeping themselves "whole" and increasing your spend.
(3) Pair effective traditional cost control approaches with explicit price control/reduction strategies, such as Medicare contracted reference-based pricing (i.e., no balance bill to patient). Other new payment models, such as bundled pricing, captitation, and global payments may also stem the tide of rising prices, but only if the negotiated price is set at a fair level and subject to resetting over time.
(4) Shift care to lower-price sites of care, such as home dialysis, freestanding infusion centers, ambulatory surgery centers.
These are just a few strategies that you should consider adding to your spend management.
A recent court ruling found that United Behavioral Health (UBH), a division of United Health Group, used overly strict criteria for denying care, potentially excluding significant number of members, including children and adolescents, from accessing behavioral health services. Specifically, the court ruled that UBH violated it's fiduciary responsibilities and also failed to recognize chronic and complex behavioral health conditions and needs.
Read the article on the court's ruling from Health Payer Intelligence.
What can you do to better understand the denial guidelines, and other policies, used by your health plan or behavioral health manager? Here are some suggestions:
Re-evaluate the results of the National Alliance's mental health deep dive in light of this ruling. Pay special attention to the section on Accreditation and Parity (page 14) to better understand that parity also applies to non-quantitative treatment limitations. The call-out box specifically refers to medical management standards limiting or excluding benefits. Check with your legal counsel and advisors re: the implications of excess denials re: these parity requirements.
Check out proposed FAQ's from HHS, DOL, Treasury on parity and the 21st Century Cures Act.
Use this form to collect data on your actual denial rates. Compare behavioral health to medical/surgical denial rates to get a clear picture of this issue for your organization.
Use this model language and consider seeking indemnification from your vendor for certain aspects of parity non-compliance.
Contract with an objective third-party vendor to audit parity compliance. Memphis area results from the national employer survey on mental health indicate that few external audits are being conducted.
Check out these resources to get a clearer picture of how the Trump Administration's proposed regulations ending drug rebates for Medicare Part D plans and Medicaid managed care plans (assuming they are finalized) impact you.
HHS Fact Sheet on the Proposed Reguations: Check out the section on "What This Means for Private Plans" for the nuances of OIG rules and possible impications for you.
Modern Healthcare "Azar Suggests Commercial Plans Will Ditch Rebates Too" Secretary Azar calls out several reasons private payers are likely to follow Medicare's lead.
For more background information:
Better understand who is likely to benefit (and who is not) from rebates going away on Kaiser Health News
Focus on the purchaser perspective of the Trump Administration's evolving drug policy. Note the potential negative consequences for you if similar changes are not made in the private sector. Michael Thompson, CEO of the National Alliance of Healthcare Purchaser Coalitions, summarizes why ending rebates would benefit employer purchasers here and here.
Refresh your memory on how rebates work and The Impact of Prescription Drug Rebates on Health Plans and Consumers. There is a lot of detail here but for the bottom line focus on the Executive Summary and Background and those sections that specifically address private insurance. Interesting to note that $23Billion was paid out in rebates to private health plans in 2016, which is 12% of point-of-purchase spending. Generally rebates reduce the net cost of the health benefit and are reflected in lower premiums.
Employers play a critical role in promoting and supporting employees and their families mental health as it impacts productivity, health status, quality of life, and health benefit costs. MBGH believes it is important for mental health and well-being to sit equally along-side physical health.
In 2019 MBGH is focusing on understanding how Memphis employers are addressing mental health in your health benefits and well-being programs and we are offering specific training and learning sessions to assist you in enhancing the effectiveness of these benefits.
As part of this focus, here are some actions you can take now:
FOR MEMPHIS-AREA EMPLOYERS ONLY: Take this national survey of current employer attitudes and future directions re: mental health strategies. Survey participants get national results for benchmarking and MBGH will get a market-specific report to inform actions to help make your mental health strategies even more effective. Please respond by January 16, 2019. Click here for a .PDF copy of the survey questions for your review. Please indicate you are a member of Memphis Business Group on Health. We ask that only one survey be submitted per organization so please coordinate with your co-workers on who will submit the survey.
Get templates and suggested contract language to strengthen your contracting practices related to mental health parity.
• Mental Health Parity Model Hold-Harmless Language
• Mental Health Parity Model Data Request
Check-out these reports for critical information and steps employers are taking to effectively manage the cost and quality of their mental health benefits.
• Mental Health Deep Dive Report (see employer checklist in Appendix 1)
• Mental Health Action Brief
• AHA CEO Roundtable Mental Health
Participate in the mental health events detailed below and throughout the year that will provide you with specific actions you can take in the workplace.
The "Purchasers Guide to PBM Quality 2018" from MBGH and the National Alliance of Healthcare Purchaser Coalitions reports on comparative performance of PBMs; provides special reports on cutting-edge PBM practices; and gives you specific action steps you can take now to improve pharmacy benefit cost and quality.
The blinded public report can be used by employers as a discussion guide with your PBM to explore and benchmark their performancce as well as set expectations for future improvements.
MBGH employer members can get an UNBLINDED report revealing specific PBM performance by emailing Cristie Travis at firstname.lastname@example.com.
Participating PBMs cover over 119 million covered lives and include:
Specific areas of importance to employers that are reported include (1) specialty pharmaceutical management, (2) outpatient quality, safety, and adherence, (3) efficiency, (4) pharmaceutical support: CAD, diabetes, mental health, (5) pharmaceutical support: tobacco, obesity, (6) program organization, (7) cultural competency, (8) price transparency, and (9) business practices.
Click here for a copy of the public report.
In this round of The Hospital Safety Grade, the percentage of Memphis hospitals with an "A" and "B" increased from 20% to 46%.
In the greater Memphis area, 11 hospitals were graded, and two (2) earned an "A," three (3) earned a "B," five (5) earned a "C," and one (1) earned a "D". No Memphis hospitals earned an "F." Methodist Olive Branch Hospital and Saint Francis Hospital – Bartlett both received an "A". Baptist Memorial Hospital Memphis, Methodist Le Bonheur Germantown Hospital, and Saint Francis Hospital - Memphis each received a "B".
"Memphis is now much closer to the national benchmark of 56% of the hospitals receiving an "A" or a "B". However, our market still has work ahead of us to reach benchmark and, as we would all want and Memphians deserve, surpass it and become a national leader in safety. Safety is not a one-and-done; it results from a culture that insists on safety every day for every patient. MBGH looks forward to seeing these improved grades sustained over time. We will then be confident that the improvements are foundational and long lasting. On behalf of Memphis employers, purchasers, and patients, we are committed to working together to make Memphis the safest community in America," said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health, the Regional Leader for The Leapfrog Group for the Memphis-area.
The Leapfrog Group, a national nonprofit aiming to improve health care quality for consumers, employers and purchasers, announced today the fall 2018 Leapfrog Hospital Safety Grades. The independent grading system assigns "A," "B," "C," "D" and "F" letter grades to general acute-care hospitals in the U.S. based on their ability to protect patients from avoidable errors, injuries, accidents and infections.
In the wake of the high stakes mid-term election, neither party can claim victory in addressing preventable errors and infection in hospitals. The fall 2018 Leapfrog Hospital Safety Grades show that 33 percent of hospitals in traditionally blue states and 32 percent of hospitals in traditionally red states earned "A's." As recently as September 2018, The Leapfrog Group testified at a hearing of the United States' Senate Health, Education, Labor, and Pension (HELP) Committee, chaired by Tennessee's Senator Lamar Alexander, offering guidance for a bipartisan approach to improving transparency of patient safety data and making progress on safety.
"The Hospital Safety Grades give the American public information they need and deserve about the safety of their hospitals. Avoidable medical errors and infections in hospitals are still the third leading cause of death in the nation, and that's not a partisan issue," said Leah Binder, president and CEO of The Leapfrog Group. "We commend Memphis Business Group on Health for making this a priority."
Developed under the guidance of a National Expert Panel, the Leapfrog Hospital Safety Grade uses 28 measures of publicly available hospital safety data to assign the grades to more than 2,600 U.S. hospitals twice per year. The Hospital Safety Grade's methodology is peer-reviewed and fully transparent, and the results are free to the public.
For more information about the Leapfrog Hospital Safety Grade, as well as individual grades and state rankings please visit www.hospitalsafetygrade.org and follow The Leapfrog Group on Facebook and Twitter. Journalists interested in scheduling interviews should email firstname.lastname@example.com.
About Memphis Business Group on Health
Since 1985, Memphis Business Group on Health (MBGH) has brought employers, with approximately 375,000 covered lives in Tennessee, together to share solutions, make connections, and provide tools to manage the cost and quality of their health benefits in an ever-changing environment. MBGH accomplishes this by providing access to critical market data, facilitating best practice sharing among the areas leading employers, and offering practical tools for successfully managing health benefits and creating cultures of health in the workplace. MBGH has been a Regional Leader for The Leapfrog Group since 2002.
About The Leapfrog Group
Founded in 2000 by large employers and other purchasers, The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. The flagship Leapfrog Hospital Survey collects and transparently reports hospital performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions. The Leapfrog Hospital Safety Grade, Leapfrog's other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents, and infections.
Two recent publications from the National Alliance of Healthcare Purchaser Coalitions make it clear that there is much work to be done to improve the cost and quality of mental health services and to deliver on the promise of parity of mental health with physical health benefits. These publications provide employers with specific actions you can take internally and with your mental health services vendors to start the work.
Use the National Alliance's latest Action Brief "Mental Health: Accelerating Action for Parity and Peak Performance" as a checklist of employer best practices; compare what you are doing now; and identify actions you need to take to better manage the cost and quality of your mental health benefits. This Action Brief (click here) lays out specific actions employers should take to (1) Know the Impact, (2) Break the Silence, (3) Ensure Parity and Affordable Access, and (4) Build a Culture of Wellbeing that includes mental health.
Meet with your health plan or behavioral health organization (BHO) about how they performed on critical purchaser requirements for mental health benefits and services in the National Alliance's report "Achieving Value in Mental Health Support: A Deep Dive Powered by eValue8" (click here for report). MBGH members have been sent codes to unblind the report. If you need another copy, please email email@example.com.
Both of these resources reveal that there is significant work that employers can do internally (Action Brief) and that health plans and BHOs can do (Deep Dive). Using the resources together gives you an understanding of the total picture and a pathway to more effectively manage the cost and quality of your mental health benefits.
A recent report from The Leapfrog Group and Castlight shows that only 1/3 of the hospitals fully-met Leapfrog's standards for bar code medication administration. Get a copy of the report here.
Most surprising, and very dangerous from a patient safety perspective, was that 42% of the hospitals were failing to scan BOTH the patient and the medication 95% of the time!
Memphis hospitals, on average, reflect this national experience, with 40% of our hospitals not meeting the 95% standard.
Note: Baptist Memorial Health Care Corporation hospitals did not report. They will report this year so we will have this information for them in the summer.
Use the report to educate your employees about the steps that should be taken for bar code medication administration to protect their safety! Especially tell your employees to be sure that when given medication, both the patient and the medication are scanned!
Click here to see how Memphis-area hospitals scored on other aspects of bar code medication administration.
On Friday, May 25, 2018, the Memphis healthcare community gathered for a screening of To Err is Human: A Patient Safety Documentary, followed by a panel discussion about shared solutions to reduce preventable medical mistakes among health care organizations throughout the Mid-South.
Hosted by the Memphis Business Group on Health, Southern College of Optometry, and the Memphis Medical District Collaborative, the event featured a sneak preview screening of Mike Eisenberg's film To Err is Human. The film, set to be released in November 2018, explores the United States' third-leading cause of death: medical mistakes, which lead to as many as 440,000 preventable deaths each year. It also follows Sue Sheridan, whose family experienced a variety of medical errors that caused long-term health issues.
Cristie Upshaw Travis, Chief Executive Officer of the Memphis Business Group on Health (far left) and Lewis Reich, President of Southern College of Optometry (far right) welcomed the filmmakers, Mike Eisenberg, Director and Producer, and Kailey Brackett, Lead Producer.
Following the film, Cristie Upshaw Travis, MBGH CEO, moderated a first-of-its-kind panel discussion and Q&A session with representatives from Memphis' four major hospital systems to address preventable medical mistakes and how their systems can work together to reduce error and improve care throughout the Mid-South. Participants (L-R) in the panel were:
Here are some highlights from the discussion:
Although patient safety is a national issue, it's especially prevalent in Memphis. According to the spring 2018 Leapfrog Hospital Safety Grades, just 20 percent of hospitals earned an A or B. This compares to 94 percent in Nashville, 81 percent in St. Louis, 62 percent in Birmingham, Alabama, and 50 percent in Jackson, Mississippi.
Baptist Memorial Health Care Corporation's Blue Brain project asks staff to "show their thinking" so they can be properly trained to approach complex work and situations appropriately. Baptist has reduced bedside blood culture contamination by 50 percent through this method.
Methodist Le Bonheur Healthcare requires all associates and medical staff to complete patient safety training in order to practice in their facilities or be scheduled for work.
Regional One Health focuses on the actual numbers of medical errors, not the error rates. Focusing on the numbers keeps the patient impact front-and-center -- each number is a patient that experienced harm.
Saint Francis Hospital Memphis senior leaders audit specific key processes, such as surgical safety measures, in real-time, to monitor compliance and identify opportunities for improvement.
At the end of the discussion, it was suggested that the health systems identify a patient safety action they could all take together, at the same time, to have a significant improvement across the entire community. The health systems all going tobacco free campus on the same day increased the visibility of the harms from tobacco use; showed the health system leadership on a critical health issue; and provided a community standard for what it meant to work in healthcare in Memphis. A similar approach can be considered for patient safety.
Interested learning more? Contact Cristie at email@example.com.
On May 11, the Trump Administration released "American Patients First," the President's blueprint to lower drug prices and reduce out-of-pocket costs for consumers. The document identifies four challenges: 1) high list of prices for prescription drugs, 2) lack of price negotiation tools in federal health programs, 3) high and rising out-of-pocket costs for consumers and 4) US footing the bill for lack of foreign countries' investment in research and development.
The plan identifies four key strategies for reform in two phases, including actions the President may direct HHS to take immediately, and actions HHS is considering, on which feedback is being solicited. The four strategies are: 1) increased competition, 2) better negotiation, 3) incentives for lowering list prices, and 4) lowering out-of-pocket costs.
Click here to read the full Health Policy in Transit brief, focused on the employer's perspective.
Note our new time!
Wednesday, May 2, 2018
Rhodes College
Bryan Campus Life Center
McCallum Ballroom, second floor
8:30 am - 11:30 am
A hot breakfast will be served!
Join us as we recognize our CEO Culture of Health participants that met program requirements in 2017 and area hospital(s) for their performance in quality and safety.
In addition to our recognitions you will participate in "Lightning Rounds" where three of our Annual Supporters will give you 15-minute "lightning-fast" presentations! Moving around the room from presentation to presentation in small groups will keep you active, engaged, and provide you a networking opportunity. And you will leave the meeting with ideas about how to better engage your employees and refresh your health and wellness programs.
This year we will be taking pictures of teams and their award during the Lightning Rounds as well as recognizing you during the awards part of the meeting.
MBGH Members, Annual Supporters, and CEO Culture of Health participants are all invited!
Thank you to our sponsors: BlueCross BlueShield of Tennessee and Cigna!
Click here to register.
Our Lightning Round contestants are:
Adventia Wellness's patent-pending software identifies early on individuals at hidden and rising risk for heart attacks, strokes and diabetes. Adventia applies the latest science not typically used by physicians or in corporate-sponsored wellness programs and draws on lessons from behavioral health, which helps drive engagement and sustain change. A four-year corporate wellness program with Varsity Spirit in Memphis helped participants lose weight and waist circumference, reduce bad cholesterol and triglycerides without medications, and returned diabetic and pre-diabetic glucose levels to normal. Adventia Wellness has been offered through providers and programs in four states.
LifeSpeak is being presented by MBGH Annual Supporter Connect Healthcare Collaboration. LifeSpeak delivers the world's leading experts directly to employees through an easy to use digital well-being platform. The short, expert-led videos and podcasts, give employees easy access to over 1,800 custom produced sessions and tip sheets. Topics include preventive health, mental health, physical conditions (such as diabetes), marital relationships, parenting, financial well-being, and more!
WellDoc's BlueStar diabetes management platform is an FDA-cleared diabetes personal assistant for your employees. with type 2 diabetes. BlueStar provides personalized, real-time feedback that improves self-management. Features include patient-to-provider connection, in-app education adapted from the American Association of Diabetes Educators, and 24/7 tailored self-management support. BlueStar provides significant A1c reduction on average of 1.7 to 2.0 points, based on clinical outcome data from randomized trials and real-world programs.
A new study released by the University of Southern California found that the 1.9 million people that filled 9.5 million prescriptions in the first 6 months of 2013 overpaid for those prescriptions 23% of the time for a total of $135 million in overpayments.
Turns out, their copay was higher than the full cost of the drug. Referred to as a "clawback", the middlemen that handle drug claims essentially "claw back" the difference between the higher copay and the lower cost of the drug from the retail drug store.
Although the amount per prescription that is clawed-back is often small, the frequency with which this happens results in significant overpayments. Clawbacks on generic drugs averaged $7.32 and were $13.46 on brand-name drugs.
Patients aren't often told they could pay less if they don't use their insurance.
Some insurance companies actually prohibit pharmacists from telling paitents. On March 14, bi-partisan federal legislation was introduced to ban "gag clauses" prohibiting pharmacists from informing patients they could save money if they paid in cash. Several states have already passed legislation to rein in clawbacks and prohibit gag clauses.
There has been increased legal activity around clawbacks and gag clauses in recent years with cases against UnitedHealth, Cigna, Humana, and OptumRX. This month, a federal judge allowed a proposed class action law suit against Cigna to proceed.
Employers should review their health plan and PBM contracts to determine how these types of overpayments are handled. Gregory I. Madsen of Innovative Rx Strategies recommends that employers include "the lowest of" language to ensure that their employees pay the lowest of the discounted ingredient cost, the pharmacy's usual & customary, or the co-pay, and not just automatically the co-pay.
Information for this article was provided by Bloomberg News, CFO Daily News, and Kaiser Health News.
On March 13, 2018, the pronouncement was made that in 2016 price, once again, was the major reason the U.S. spends twice as much on health care as other developed countries (JAMA.2018;319(10):1024-1039).
At the end of their article the authors frame this a health policy issue: "As patients, physicians, policy makers, and legislators debate the future of the health care system, data such as these are needed to inform policy decisions."
Categorizing U.S. health care prices as a health policy issue seems somehow to let the rest of us off the hook. But how can we leave it up to policy makers when the prices employers and employees are paying today are the real underlying cause of their increasing spend?
Perhaps there has not been enough private sector action on price because the significance of the issue has not been recognized. A new report from Memphis Business Group on Health lays out the case that price deserves increasing employer attention.
The complete report, based on analyses conducted by the Health Care Cost Institute (HCCI) (http://www.healthcostinstitute.org/) and published in HCCI's 2016 Health Care Cost and Utilization Report (January 2018) and Issue Brief #13 (August 2017), is available to MBGH employer Members and Annual Supporters. The report includes MBGH-prepared charts, graphs, and analysis focused on the points of interest to employers, including upper-level management, that make the case for focus on price.
Highlights from the report include:
Please refer to the publications on http://www.healthcostinstitute.org/ for detailed descriptions of data sources, methods, and limitations of this information.
It is not surprising that as utilization has declined (almost across the board), price has increased. If the health care system wants to maximize revenue while experiencing declining utilziation, the only reaction is for them to increase prices. Since employers and their employees and families are paying for these price increases, they are the ones bearing this burden; often to the detriment of their own business and personal financial status.
Although prices in Memphis were consistently below the U.S. average (2012-2014), we know that the U.S. average is too high and is increasing significantly across all categories and local rates are increasing similarly (except for inpatient). Memphis may be fairing better than many markets but we should not take comfort that our high prices are lower than high prices in other markets.
The impact of price on spend means that employers need to change their purchasing approach, moving away from the traditional focus on discounts, to more targeted purchaser strategies that unpack the growth spend and address the underyling factors of price, utilization, and quality/safety. The MBGH report suggests strategies employers should deploy, such as analyzing their own data to identify price and utilization trends; pegging payments to Medicare prices; setting fair prices in new payment models; and selecting netowrks with high quality/safety performance.
If you work for an MBGH Member employer or Annual Supporter and have not yet received your copy of the complete report, please email email@example.com for a copy.
Recent news on the economic toll of the opioid crisis http://bit.ly/2ChaWAs and the impact on employers in terms of lost productivity and direct/indirect for their affected employees and families raises the question: what is the employer's role in the opioid crisis? This is a presentation from MemphisBGH's 2017 learning session outlining specific steps employers can take: http://bit.ly/2Hiuyrx. Thank you to the National Safety Council for providing this guidance.
The National Alliance of Healthcare Purchaser Coalitions/MBGH Action Brief "Hope and Healing for Mental Illness is Possible" lays out the challenge for employers this way: " Mental health conditions are the leading cause of disability worldwide. As importantly, untreated depression and anxiety are leading causes of lost productivity and effectiveness in the workforce. In the U.S., about one in five adults will experience mental illness in a given year, 60 percent of whom don't get help. Many who do reach out face a daunting labyrinth of high costs, a dearth of providers, and unsuccessful treatment, leading to waning motivation, hopelessness, and progressively worse symptoms."
This is not a pretty picture for employers, but most importantly, it is not a pretty picture for your employees and their families. The Action Brief discusses how employers can take five specific actions to address these challenges:
Click here to get a copy of the Action Brief.
Other Actions for Employers
Use the Working Well: Leading a Mentally Healthy Business toolkit from the Northeast Business Group on Health, to (1) know the impact (2) break the silence (3) deliver affordable access and (4) build a culture of well-being. Find valuable employer action steps, resources, and case studies to help shape your approach to mental health.
Read this blog, from our sister-coalition the Minnesota Health Action Group, on actually delivering on the promise of mental health parity.
Attend the Methodist Healthcare Dennis H. Jones Living Well Network mental health breakfast on March 6 where Marlie Matlin, Academy Award-winning actress and mental health activist, will share her personal story and highlight the importance of acceptance and help for those with mental health concerns. There will also be breakout session on opioid abuse, domestic violence, and adverse childhood events (ACEs). Click here for more information and to register.
Get results, later this year, from the National Alliance and MBGH deep dive into how health plans and mental health-specialty managers perform on essential elements of mental health services provided to employers and employees.
March is national colorectal cancer screening month!
Screening Matters
According to the National Colorectal Cancer Roundtable, "Colorectal cancer is the second most common cause of cancer death in the U.S when men and women are combined. Yet it is one of the most preventable.
The business community has an important role to play in promoting colorectal cancer screening and much to gain on saving on health care costs, promoting a healthy workforce with increased productivity, and demonstrating corporate social responsibility.
Join the national and Tennessee effort to get 80% of adults age 50 and older regularly screened for colorectal cancer."
If we reach 80%, there can be fewer than 200,000 colorectal deaths in less than 20 years. Tennessee consistently ranks above the national rate for colorectal cancer and colorectal cancer mortality so we have s significant opportunity to save lives right here in our state.
Campaign Support is Available
1. Start your colorectal cancer screening campaign in March, and continue it through the rest of the year!
Sign the corporate pledge at http://nccrt.org/80-2018-pledge/
2. Have a colorectal cancer awareness event or highlight colorectal cancer screening at your next health fair
Contact Cristie Upshaw Travis at email@example.com if you want to learn more about Gastro One participating and actually setting up colonoscopy appointments for your staff.
3. Use turn-key communication tools and material for ease of implementation:
National Colorectal Cancer Roundtable: http://nccrt.org/resource/2017-80-2018-communications-guidebook-recommended-messaging-reach-unscreened/
Click here for more information on how employers can support increased screening
Love Your Colon Campaign: www.loveyourcolon.org:
February 5-9, 2018 is "It's Quittin' Time in Tennessee" week, a statewide campaign to promote awareness of and resources for quitting smoking. Click here to download the graphic and use it in your communications to show your employees this is a community-wide campaign! Feel free to continue, or even start, your own campaign in the weeks and months after the official week.
The evidence is clear why employers should care:
Frame this week as a kickoff to a campaign around tobacco cessation and plan to celebrate those that quit at the Great American Smokeout in November!
Here are some easy to implement suggestions, and resources, but be creative! We will post more specific "It's Quittin' Time In Tennessee" material as it becomes available.
Be sure your employees know the benefits you offer them! This is a great week to highlight all the insurance benefits and tobacco and smoking programs you offer.
Consider a daily employee communication that week. You may want to take a page each day from 10 Things You Should Know About Quitting Smoking or Plan to Quit Cards
NEW: Offer, or announce, upcoming, smoking cessation classes. Share information about UT Health Science Center's research study focused on helping people manage their weight when the quit smoking. There are no costs for those that qualify to participate and they receive telephonic smoking cessation counseling, free Chantix, as well as weight managent support. Employees can call 901-448-2000 to learn more and checkout the website at htttps://www.fitandquit.org.
Here are some general resources you will find helpful:
On December 7, 2017, The Leapfrog Group announced Le Bonheur Children's Hospital has been named to its 2017 national list of Top Children's Hospitals. The elite award is one of the most competitive honors American hospitals can receive in safety and quality. The winning facilities were officially recognized at Leapfrog's Annual Top Hospitals Ceremony in Arlington, VA.
Cristie Upshaw Travis, CEO of the Memphis Business Group on Health, the Regional Leader for the Leapfrog Group in west Tennessee, north Mississippi and eastern Arkansas, and Acting Chair of the Leapfrog Group Board of Directors, presented the award to Le Bonheur. "For 10 years I have been recognizing Tennessee's Top Hospitals, but this is the first time a Memphis-area hospital has made the list. I am so honored to recognize Le Bonheur's commitment and achievements in quality and patient safety and thank them for the work it took to perform at this level", said Travis.
Donna Vickery, Director of Quality Improvement and Patient Safety at Le Bonheur, accepted the Top Hospital award from Leah Binder, Leapfrog CEO, and Cristie Upshaw Travis, MBGH CEO and Acting Chair of the Leapfrog Group Board of Directors.
This year, Leapfrog recognized 109 Top Hospitals across the country. Of those, 10 were Top Children's Hospitals, 45 Top General Hospitals, 18 Top Rural Hospitals and 36 Top Teaching Hospitals.
"Leapfrog Top Hospitals are the nation's role models for putting patients first," said Leah Binder, president and CEO of The Leapfrog Group. "We congratulate the Boards, management, clinicians, staff and volunteers whose dedication makes all the difference."
The Top Hospital award is given to teaching, general, rural and children's hospitals that publicly report their performance through the Leapfrog Hospital Survey and meet the high standards defined in the Top Hospitals Methodology. This includes infection rates, maternity care and a hospital's ability to prevent medication errors, among other standards. To see the full national list of institutions honored as 2017 Top Hospitals, please visit www.leapfroggroup.org/tophospitals.
On October 31, 2017, the Leapfrog Group released their latest Hospital Safety Grade for over 2,600 hospitals in the US, including 10 hospitals within a 50-mile radius of Memphis. Memphis Business Group on Health is the Regional Leader for The Leapfrog Group in western Tennessee, northern Mississippi and eastern Arkansas.
Each hospital is assigned a grade of A,B,C,D, or F reflecting their overall performance in keeping patients safe from preventable harm and medical errors.
The grades are based on performance measures from the Centers for Medicare & Medicaid Services, the Leapfrog Hospital Survey, the Agency for Healthcare Research and Quality, the Centers for Disease Control, and the American Hospital Association. Hospitals have access to the full methodology and are given an advance preview period. As Leapfrog points out "the grade is calculated by top patient safety experts, peer reviewed, fully transparent, and free to the public."
In the Memphis-area, Saint Francis Hospital-Bartlett was the only hospital to get an A. Even with this achievement, they didn't sit on their laurels. As Chris Locke, Saint Francis-Bartlett CEO, put it on News Channel 3, "Although we are an A today, I tell our staff it doesn't mean something bad can't happen here…We have to stay on our toes." This is the attitude of an A hospital. Never relaxing; putting the patient first every minute of the day; using their A grade to recommit to patient safety.
Saint Francis-Bartlett
Methodist Germantown
Baptist Collierville
Baptist DeSoto
Methodist North
Methodist South
Methodist University
Saint Francis-Memphis
Baptist Memphis
Regional One
Source: Hospital Safety Grade, downloaded from HospitalSafetyGrade.org on 11/28/17. Note: Hospitals not receiving a grade did not have sufficient volume to calculate performance. Pediatric and other specialty hospitals are not assigned a grade.
Click here to get the details on why these hospitals were assigned the grades they received.
As you can see, other Memphis hospitals earned lower grades for safety, and they would be wise to take the same approach as Saint Francis-Bartlett: use their grade to push for progress. However, some hospitals tried to explain away their poor grades. Explanations included:
People in Memphis need, and deserve, to know this hospital safety data. More than 500 people die every day in the United States due to problems with safety in hospitals, like errors and infections. Memphis hospitals should be leading the way toward saving lives, not trying to explain away their poor grades. The humble approach that Saint Francis-Bartlett took in earning their A is a model for all of us on service to people who entrust their lives to a hospital.
Memphis Business Group on Health's new Clinical Advisory Committee serves as a vehicle for understanding the priorities and challenges of Memphis-area self-insured employers so Committee member organizations can deploy innovative programs, services and solutions to meet those needs and contribute to their own overall success.
Initial members include:
Over time the Committee will grow to a maximum of 10 member organizations.
The Committee will work together as a team and on a one-on-one basis with MBGH to explore and create solutions for priorities such as:
According to Cristie Upshaw Travis, MBGH CEO, "At our August meeting our guest speaker, Scott Conard MD, reminded us all that disease is the enemy. With a focus on this point, this Committee is our place to engage directly with the clinical community to help MBGH and participating organizations create solutions that are win-win-win for employers, patients, and providers. We are committed to working together to defeat the common enemy of disease".
For more information on the Clinical Advisory Committee contact Cristie Upshaw Travis at firstname.lastname@example.com.
areas where there is significant variation in PBM performance, areas where PBMs in general are successful, and where they all need to improve.
Participating PBMs cover over 250 million covered lives, 80% of the market, and include:
Specific areas of importance to employers that are reported include (1) program organization; (2) efficiency & appropriateness; (3) specialty pharmaceuticals; (4) outpatient quality, safety, & adherence; (5) pharmaceutical management in chronic disease and behavioral health; (5) pharmaceutical management for tobacco cessation and weight management; and (6) business practices.
Click here for a copy of the public report.
Congratulations to Resolve MDx, who was voted the "best slam" by judges at MBGH's August 23, 2017 Annual Conference "Innovation as Strategy".
As Christer Czajkoski of Resolve MDx put it during his slam, what is the most expensive drug in the world? The one that doesn't work!
Resolve MDx deploys their intelligent prescribing solution, IQRx™, to enable the right drug, in the right dose, for the right individual.
Often described as personalized or precision medicine, Resolve MDx uses pharmacogenetic testing to better understand how an individual's genetic make-up impacts their response to medications. This testing, combined with IQRx, allows physicians to develop strategies and to optimize drug therapies for the patient based upon their unique characteristics, minimizing adverse drug reactions and drug-drug interactions.
Learn more about Resolve MDx at http://www.resolve-health.com/home.html.
Thank you as well to our two other slammers! Nic Patee of Work Right, demostrating the dorsaVI technology that helps employers better understand how employees are actually doing their job so work can be adjusted to minimize injuries; and Scott Vogel of Regional One's Center for Innovation who tested out the concept of a "genius bar" where patients can meet with clinical technologists to learn how to use technology to better manage their own health.
Slammers had to present their product or concept; engage the audience; and build in a little entertainment: all in less than 7 minutes! Thanks to the audience as well for encouraging each of the slammers. A good time was had by all.
MBGH is partnering with Catalyst for Payment Reform (CPR) to provide discounted access to online courses desinged to help get better value for an organization's health care spend.
MBGH members, CEO Culture of Health participants, and HR/Benefit professionals at Partner and Patron-level conference sponsors are eligible for the discounts.
The 100-Level Course: Introduction to High-Value Health Care Purchasing is designed for benefit managers seeking to understand the marketplace and initial steps they can take. The regular price is $249. MBGH participants pay only $186.99 (25% discount)
The 200-Level Course: Strategies for High-Value Health Care Purchasing is designed for benefit manager seekiing to understand specific high-value strategies and take action. The regular price is $349. MBGH participants pay only $261.99 (25% discount)
Both courses are eligible for SHRM and HRCI continuing education credits.
Click here to learn more about the courses. Click "enroll today" on this website to get access to detailed course descriptions.
Contact Cristie Travis at firstname.lastname@example.com to request your coupon code and registration link.
We are excited to have these bright minds, full of innovative ideas, join us at MBGH's August 23 Wellness & Health Benefits Conference "Innovation as Strategy". More speakers will be announced soon! Click here to learn more and register!
Top Row: L to R: Roz Murray, Project and Research Manager, Catalyst for Payment Reform Innovation: Innovative Benefit Designs That Work; Greg Mansur, Principal, PwC, Innovation: Next Generation Benefit Strategies; Scott Conard, Physician, Author, Innovation: Creating Value Through Population Health
Middle Row: L to R: Laura Hammill, Chief People Officer, Limeade, Innovation: Moving from Wellness to Well-Being; Laurie Lee, Executive Director, State of TN Employee Benefit Plans, Innovation: Paying for Value
Bottom Row: L to R: Barbara McClanahan, Faculty, University of Memphis, Innovation: Innovation as a Strategy; Kristof Stremikis, Senior Manager, Pacific Business Group on Health, Innovation: Surviving Health Policy Changes (Again)
Use these resources to manage the cost and quality of your health benefits.
ACA/AHCA Comparison Tool: Use the Kaiser Family Foundation's tool to compare the provisions of the American Health Care Act passed by the U.S. House of Representatives on May 4, 2017 to the existing ACA
2016 Employer Health Benefits Survey ChartPack: Get slides from the Kaiser Family Foundation/Health Research & Education Trust 2016 Employer Health Benefits Survey to help plan your benefit design for 2017 and use them in your presentations to others to support your decisions.
Employer Role in the Opioid Epidemic: Download the National Safety Council Employer Kit to get a guide on "The Proactive Role Employers Can Take: Opioids in the Workplace' as well as tools to review and update your benefits and drug-free workplace policies, fact sheets, safety talks, and posters. You will be surprised how much opioid abuse impacts your organization and the steps you can take to help your employees and mitigate your risks and costs.
Hospital Safety Grade: See how the hospitals in your network fared on the latest Hospital Safety Grade. If you have Methodist Olive Branch Hospital and Saint Francis Hospital Bartlett in your network, then you have access to the only 2 hospitals that scored an A in our market! If your network hospitals have a C or worse, ask them why and what they are doing to improve the care of the employees and their famiies your are sending them!
Vox Video on Hospital Responses to Hospital Acquired Central Line Infections: Learn how some hospitals respond to hospital acquired infections like the airline industry (zero tolerance) and others like the automobile industry (just the risk associated with driving). Did you know that Methodist Olive Branch, Methodist Germantown, Methodist University, Methodist North and Saint Francis Bartlett all had 0 central line infections in the latest Hospital Safety Grade? Check out how your network hospitals compare using the Hospital Safety Grade link above. Click on "view the full score" to see infection rates and other details.
To drive collaboration to control cost, reduce waste and maximize effectiveness of specialty drugs, the non-profit National Alliance of Healthcare Purchaser Coalitions (National Alliance) has developed stakeholder guidelines and an engagement framework.
"Specialty drugs are the fastest growing area of spend for employers today," said Mike Thompson, National Alliance president and CEO. "While these new drugs are truly innovative and important, the specialty drug marketplace itself is dysfunctional with high cost, high variation and high waste. We need to collaborate with stakeholders to wring out the costs of poor quality and unwarranted cost, complexity and conflicts."
The Five Rights framework targets critical issues and opportunities for specialty stakeholders including manufacturers, providers, health plans, and pharmacy benefit managers. The framework outlines key areas for each stakeholder to improve and was developed to raise purchaser expectations for industry stakeholders to help them better understand, evaluate and improve the specialty drug marketplace.
The Five Rights are: Right Drug, Right Price, Right Place, Right Support and Right Data. Employers should use the stakeholder engagement framework to evaluate how specialty drugs are managed by their PBM and health administrator and work with their vendors to take actions to bring their programs into alignment.
The framework was developed as a collaborative effort of the National Alliance and several purchaser-led member coalitions including the Minnesota Health Action Group, Midwest Business Group on Health and the Florida Health Care Coalition. The information is being shared with purchaser coalitions across the country.
"After two years of intensive study, Action Group members developed this framework to offer a common ground for all stakeholders," said Carolyn Pare, president and CEO for the Minnesota Health Action Group, developer of the initial Five Rights. "Offering a road map for the Right Drug, Right Price, Right Place, Right Support and Right Data, this framework provides insights for each stakeholder to do their part to deliver on that promise."
All moms want to give their baby a healthy start. But far too many hospitals are falling short of national quality metrics for things like early elective deliveries, C-sections, and episiotomies. A new report from @TheLeapfrogGroup and @CastlightHealth explores these issues that underscore why a family's choice of birth hospital is so important. http://bit.ly/2l7ZYJK
Nationally, hospitals' efforts to reduce their rate of early elective deliveries has been a tremendous success, declining to just 1.9% compared to 17.0% in 2010. The analysis also showed the rate of episiotomies has fallen to 9.6%. While this represents progress from the rate of 13.0% first reported in 2012, this rate is still significantly higher than Leapfrog's target of 5% or less. The C-section rate of 25.8% is virtually unchanged from the prior year and is still higher than Leapfrog's target rate of 23.9% or lower.
There has been significant improvement in the rates of early electve deliveries and C-sections in the past year in the Memphis market. Only Saint Francis Bartlett had an early elective delivery rate above 1% (3.3%). All hospitals, except Saint Francis Bartlett, either decreased their C-section rate or kept it constant. The hospital average C-section rate dropped from 28.0% to 24.9%. Click here to get hospital-specific results in Memphis.
"We must remain vigilant and continue to demand public reporting of this information to ensure the safety of mothers and their children, as well as to educate employers, purchasers and women themselves who have a powerful stake in the quality of maternity care," Leah Binder, president and CEO of @TheLeapfrogGroup addresses that although the rate of early elective deliveries declined to near zero, there is still a lot of work to do to continue to reduce rates of C-section and episiotomies. Learn more about their new report on hospital performance: http://bit.ly/2l7ZYJK
Employers continue to migrate toward high deductible health plans, but as more employers adopt this strategy and more employees are covered in these plans, there is an increased need to focus on avoiding unintended consequences such as forgoing needed care.
Check out this white paper from Abbvie which describes the current environment for high deductible plans, the potential challenges, and recommendations on steps employers should take to be sure these plans are effective.
FOR IMMEDIATE RELEASE – February 16, 2016
Contact: Bailey Jacobs, U.S. Chamber Foundation, 202-463-57
Memphis Business Group on Health Named a Winner of the Inaugural Health Means Business Healthy10 Awards
February 16, 2017—The U.S. Chamber of Commerce Foundation's Health Means Business campaign named Memphis Business Group on Health one of the 10 winners of the inaugural Healthy 10 Awards, in the category of workforce health.
Cristie Upshaw Travis, MBGH CEO, and Claire Revels Shapiro, Director of Human Resources at Rhodes College and President of the MBGH Board of Directos, accepted the award. "MBGH accepts this award on behalf of the 64 employers that are creating cultures of health at the workplace and changing what it means to work in Memphis. This initiative, which also supports Healthy Shelby and Healthier Tennessee, results in health for our employees, success for our organizations, and, through our collective action, economic development for Memphis" said Travis in a pre-taped acceptance speech. Shapiro was at the awards ceremony to accept on behalf of MBGH.
The Health Means Business 'Healthy10 Awards' were created by the U.S. Chamber of Commerce Foundation and the Robert Wood Johnson Foundation as a way to honor ten outstanding business-led initiatives or cross-sector collaborations between local businesses and traditional and non-traditional partners to improve community wellness and access to economic opportunity.
"The Memphis Business Group on Health's CEO Culture of Health initiative helps empower business leaders to be health champions," said Marc DeCourcey, Senior Vice President of the U.S. Chamber of Commerce Foundation. "Business leadership is vital to creating a culture of health and it's an honor to recognize this program."
The Chamber Foundation announced the winners of the Healthy10 Awards on February 16 at a ceremony in Washington, D.C. Learn more about the awards program here.
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The U.S. Chamber of Commerce Foundation is dedicated to strengthening America's long-term competitiveness. We educate the public on the conditions necessary for business and communities to thrive, how business positively impacts communities, and emerging issues and creative solutions that will shape the future.
The U.S .Chamber of Commerce is the world's largest business federation representing the interests of more than 3 million businesses of all sizes, sectors, and regions, as well as state and local chambers and industry associations.
Memphis Business Group on Health has joined with the National Alliance of Healthcare Purchaser Coalitions (formerly National Buisness Coalition Health) calling upon the Trump Administration and US Congress to adopt specific principles as they consider "repeal and replace" or even "repair".
These principles aim to continue the advancements achieved through the ACA for new payment models moving from volume to value, increased transparency of quality and safety for providers, continued emphasis on research to identify most effective treatment, and support for employer-sponsored coverage including tax exclusion of benefits, flexibiity and innovation.
Click here to read the piece.
Cristie Upshaw Travis, MBGH CEO, serves on the Board of Governors of the National Alliance of Healthcare Purchaser Coalitions.
Memphis Business Group on Health and HealthCare 21 Business Coalition Awarded Grant for Innovative Practices in Healthcare Payment Reform
MBGH and HC21 are among the first four coalition projects to be awarded grants by the Purchaser Value Network to support our work across Tennessee to advance the adoption of new value-based payment models among both employers and providers. Key partners in our project include the State of Tennessee Health Care Innovation Initaitive, State of Tennessee Employee Benefit Administration, Cigna, BlueCross BlueShield of Tennessee, self-insured employer members of MBGH and HC21, and other providers.
The Purchaser Value Network has awarded initial matching grants, up to $50,000 each, to non-profit regional business coalitions implementing innovative practices in value-based purchasing and healthcare payment reform.*
Health Care 21 Business Coalition and Memphis Business Group on Health were awarded $37,500 to explore models of payment reform with two employers to align with current state and national efforts in 2018.
Colorado Business Group on Health was awarded $50,000, to promote advanced primary care by integrating the Comprehensive Primary Care Plus (CPC+) incentives, a national advanced primary care medical home model to strengthen primary care through regionally-based multi-payer payment reform and care delivery transformation. Aligning the commercial and governmental purchasers in this market will help increase quality improvement, according to physician practices across the state.
Florida Health Care Coalition received $50,000, to finish developing and promoting a risk-stratified bundled payment for cardiac care, a project started under a Centers for Medicare and Medicaid Innovation grant. This initiative aligns commercial and governmental cardiac purchasing strategies across the Florida market.
Northeast Business Group on Health received $50,000 to convene employers, health plans and a hospital system to develop a multi-stakeholder pilot intervention to reduce C-sections in the state. Intervention methodologies will include a bundled payment for hospital-based maternity care or a blended case rate for vaginal and C-section deliveries.
Additional grants will be awarded throughout the year to further support initiatives in areas such as maternity care payment redesign, accountable care organizations, prescription drug value-based purchasing initiatives, and redesigning complex care management to reduce emergency department usage.
*Funding provided by the Laura and John Arnold Foundation
The Purchaser Value Network, an initiative of the Pacific Business Group on Health, aims to accelerate the adoption of high value healthcare delivery and payment models through policy advocacy, education and purchaser engagement. The network seeks to inject purchaser perspectives and innovative best practices into federal and state policy decision making, educate employers about value-based purchasing and advocacy opportunities, and aligns three critical purchaser sectors—private employers, states, and the federal government—around evidence-based practices. For more information, visit www.pvnetwork.org.
Cristie Upshaw Travis, MBGH CEO, is a member of the Purchaser Value Network national Advisory Committee.
Pete Durand, CEO of RivalHealth, will keynote MBGH's Annual Awards Luncheon on April 27, 2017 11:30-1:00 at Rhodes College. He will also sit in on our CEO Culture of Health Learning Session at 10:00 that morning.
Fitness, it's what Pete does. A recovering engineer, MBA and somewhat scarred/successful entrepreneur, he decided that pouring passion into your career makes sense only if you REALLY believe in what you do.
Eight years ago Pete started RivalHealth, a company focused on delivering fully customized and individual exercise/nutrition (=fitness) solutions to individuals, companies, schools and universities. RivalHealth is now in all 50 states, 12 countries and 66 languages.
A successful corporate executive and entrepreneur at companies like Kimberly Clark, Eaton and General Electric, Pete was inspired to start RivalHealth because of the powerful impact proper fitness and nutrition can have on all walks of life. He is an accomplished triathlete, exercise junkie, nutrition nut and NASM Certified Personal Trainer (CPT). Pete holds a BS in Industrial Engineering, an MBA and is a former Ernst & Young Entrepreneur of the Year for the Carolinas.
Pete is an inspiration to both employers and employees and his passion shows! You don't want to miss this opportunity to be uplifted by his message and head back to work ready to implement some of his practical, yet impactful, suggestions.
Click here to add the CEO Culture of Health Learning Session on your calendar and here to add the Annual Awards Luncheon. Click download event to get calendar appointment. Registration for both events will start in March.
HealthPartners Institute and the National Commission on Prevention Priorities (NCPP) announced the 2017 update of their Ranking of Clinical Preventive Services, which compares 28 of the most cost-effective and life-saving evidence-based interventions.
Three of the most cost-effective and life saving conversations a clinician can have with a patient include:
Advising adults to quit smoking;
Encouraging children and teens to not start smoking; and
Getting vaccines
This effort, a major initiative in the NCPP's Prevention Priorities work, demonstrates the value of evidence in supporting a healthier nation.
Cristie Upshaw Travis, Memphis Business Group on Health CEO, is a commission member of NPCC.
Click here to read more and learn about the NCPP.
From KFF.org: "On December 20, 2016, the Health Resources and Services Administration updated the preventive services for women by accepting the recommendations of the Women's Preventive Services Initiative, convened by the American College of Obstetricians and Gynecologists (ACOG), and comprised of representatives of national groups with expertise in women's health. The committee reaffirmed the services for women that were recommended in 2011 and added one new one for mammography."
"Table 1 summarizes all of the preventive services affecting women recommended by these three committees that the ACA requires plans to cover without cost sharing."
Click here to read the full article including highlights of the updated reqguirements.
To reach more Memphis-area residents to help them learn about the Hospitals Safety Grade and see results for local hospitals, MBGH ran an ad on Facebook for a week last fall. Click here to read about Memphis hospital grades.
The results were impressive with 7,920 people reached and 696 engaging with the post by clicking on the map or going to the Hospital Safety Grade website for more information.
Although it makes sense, it was interesting to note that as people aged they were more likely to engage with the post with almost 50% (311) of those that engaged being age 55-64. This age group has a higher likelihood of being hospitalized than those under age 55.
And, in a similar finding, 91% (634) of those that engaged were female. We all know that women are the most engaged in their family's health.
Other findings include:
91% of post engagements were from smart phones
70% of the clicks to the website occurred Friday-Sunday
These findings help us define the key audience for the Hospital Safety Score and social media provides us a flexible, customizable platform to reach that audience.
You can use the results of this ad to help you plan how to best reach your employees with the Hospital Safety Grade information. You can also use similar analyses to better understand how employees are engaged with your other health and health benefit communications. Refresh your memory on the employee segmentation recommendations that Benz Consulting made at our 2016 Annual Conference here. Download the presentations and see the Benz presentation at page 142.
From the desk of Cristie Upshaw Travis, CEO, Memphis Business Group on Health
As announced in early December 2016, I am honored to have been elected to the Board of Directors of the National Quality Forum (NQF).
Do you know how much the work of NQF matters in Memphis? For example:
And, because of NQF, we can compare the quality and cost of care we have here in Memphis to other communities across the country since each community is using the same measures and data to evaluate care. Through the NQF we have standardized our measures so we can track our own improvements over time and identify best practices both within Memphis and elsewhere to rapidly advance care delivery.
Since 1997, MBGH has focused on working toward and advancing value-based purchasing in the greater-Memphis market. We defined value-based purchasing as a function of health status/outcomes, patient experience, and cost. Right away we were challenged with the fact that although employers knew their costs, but they had no idea what they were getting in terms of the health status/outcomes for their employees or the experience their employees were having as they navigated the healthcare delivery system.
We were not alone in lacking this information and understanding. The nation as a whole only had crude ways of evaluating the quality and experience of care using such measures as mortality, length of stay, and cost per stay/day in the hospital. Unfortunately, these early measures didn't really help us understand the underlying issues that were driving these results, nor did they provide information upon which we could make purchasing decisions or help employees select providers.
Fast forward 20 years later to 2017 and we are now operating in a very different world. In fact, there are many who say we have too much information now! So, how do we decide what measures to use and when to use them?
The National Quality Forum (NQF) was established to help us answer these questions. Through it's measure endorsement process, NQF:
Calls for measures that matter for health/well-being; prevention/treatment of leading causes of mortality; person and family-centered care; effective communication and care coordination; patient safety; and affordable care.
Conducts detailed reviews of proposed measures through standing committees to ensure they reflect sound science, will be useful to providers and patients, and will make a difference in improving quality.
Seeks public comment and input from any interested party during the decision-making process.
Provides oversight of committee decisions through the Consensus Standards Approval Committee which helps ensure consistency across standing committees and alignment with overall NQF goals.
Includes an appeals process through an Appeals Board.
I have always thought it was important to be actively involved in national policies that have such a significant impact on the Memphis community. After all, if we don't get involved, we may find that the measures and the quality and cost that they drive are not in our best interest. I am often the only Southerner on a committee; I am often one of only a few employer/purchaser representatives on a committee; I am often one of only a few market-focused (vs. nationally or institutionally-focused) representatives on a committee. All of these voices need to be heard during the decision-making process. And, because I am involved, I have a much deeper understanding for these measures that are critical to the quality, cost, and payment right here in Memphis.
Please let me know if you have any questions about NQF. I am also available to speak with you and your senior leadership about NQF and the role it plays in measurement and federal programs. The more we understand and the more active we are, the better this process will be for us in Memphis.
On December 3, 2016, The National Quality Forum (NQF) announced the appointment of Cristie Upshaw Travis, chief executive officer of the Memphis Business Group on Health, as well as two other new members to its Board of Directors:
According to Travis, "I am honored to be selected to serve alongside national health, healthcare, consumer, purchaser, and policy leaders as the National Quality Forum continues our commitment to lead collaboration to improve health and healthcare through measurement and quality initiatives".
In addition to serving on the NQF Board of Directors, Travis co-chairs the NQF All Cause Admissions/Readmissions Standing Committee and its Measures Application Partnership Hospital Workgroup, which advises CMS on measures for use in federal programs. She also served as Vice Chair and Chair of NQF's Consensus Standards Approval Committee.
Composed of 21 members, the NQF Board provides organizational guidance on strategic and policy issues. Representatives include key public- and private-sector leaders who represent a wide range of major stakeholders in America's healthcare system, including consumers and those who purchase healthcare on their behalf.
Other NQF Board members include:
We saw quite a bit of movement in the fall 2016 Hospital Safety Grades (formerly Hospital Safety Score) for Memphis-area hospitals:
Several hospitals raised their scores:
Unfortuantely, Saint Francis Memphis moved down from an A to a B and Methodist University moved down from a B to a C.
Methodist Olive Branch received it's first grade and it was an A. They join Saint Francis Bartlett as our Memphis-area A hospitals.
Methodist Olive Branch A
Saint Francis Bartlett A
Baptist Collierville B
Baptist DeSoto B
Methodist Germantown B
Saint Francis Memphis B
Baptist Memphis C
Methodist North C
Methodist South C
Methodist University C
Regional One Health C
Check out www.hospitalsafetygrade.org for details on these scores as well as those for 2,633 hospitals
If you are like me, you are now coming out from under the campaign and the election itself and beginning to think about the implications of the results for health reform and employer-sponsored health benefits.
Here are some articles that will help you begin to identify the key issues and strategies that are likely to emerge.
Obamacare Replacement Might Look Familiar, Kaiser Health News
Where President-Elect Donald J. Trump Stands on Six Healthcare Issues, Kaiser Family Foundation
What Bipartisan Opportunities Will the Next Congress and President Have to Improve Health Policy, Health Affairs
Presidential Candidate Donald J. Trump's Health Proposal (as of September 2016), Commonwealth Fund
WASHINGTON – Sept. 29, 2016 – The Memphis Business Group on Health received the Member Leadership Award at the National Alliance of Healthcare Purchaser Coalitions* (National Alliance) annual conference. The recipient was recognized for their efforts to improve the quality and efficiency of the healthcare delivery system and health of employees and communities.
(*Formerly the National Business Coalition on Health)
The Memphis Business Group on Health, under the leadership of CEO Cristie Upshaw Travis, has long played a critical role in encouraging and assisting Memphis-area employers to not only create a culture of health within their organizations, but to implement programs that will more broadly help the entire community. The coalition works with Tennessee hospitals, physicians, health plans, community and government leaders to drive healthcare delivery system reform.
MBGH sponsors the CEO Culture of Health initiative with 64 organizations in the Memphis-area currently participating and was a founding member of the Common Table Health Alliance (formerly Healthy Memphis Common Table) as well as Healthy Shelby. National efforts include Travis serving on the National Alliance board; as a board member and Regional Roll-out Leader for The Leapfrog Group, a hospital patient-safety organization; and co-chair of committees of the National Quality Forum, the multi-stakeholder, consensus-building organization that leads national collaboration to improve health and healthcare quality through measurement.
"Memphis Business Group on Health is a proud member of the National Alliance, learning from our sister coalitions and helping where we can to share our experience and expertise to assist purchasers nationally," said Travis. "We are honored to be recognized for our 31 years of work to create, support and sustain a culture of health at the workplace for our members and their families."
The National Alliance's Member Leadership Award is sponsored by Merck.
About the National Alliance of Healthcare Purchaser Coalitions
The National Alliance is a nonprofit network of business health coalitions, representing more than 12,000 purchasers and 41 million Americans. Its members are dedicated to driving innovation, health and value through the collective action of public and private purchasers. The organization seeks to accelerate the nation's progress toward safe, efficient, high-quality health care and the improved health status of the American population. www.nationalalliancehealth.org
Click here to register for MBGH's August 18, 2016 Annual Conference "Rethink Employee Engagement to Drive Better Results". Early registration ends July 10 and prices increase July 11.
Three more breakout sessions will be offered at 10:45. Start thinking now about which one you will attend. They are all excellent and you can only attend one!
ReThink: The Essential Role of Benefits Communication in Employee Engagement
Brandon Moore, Strategic Accounts Manager, Benz Communications
The evidence is clear that employees value their health benefits and these benefits contribute to employee recruitment, retention, and loyalty. In this session, learn how to develop and implement an employee communication strategy that reinforces the value of these benefits by communicating year-round; using multiple channels to reach employees; integrating data to identify key goals; and targeting messages to drive action.
ReThink: Consumerism: Aligning Employees & Employers
Tom Parry, President, Integrated Benefits Institute
Many employers are moving to consumer directed health plans (CDHPs) to better manage costs of health benefit plans. However, decisions employees make in these plans impact not only health benefit costs, but also short-term and long-term disability and productivity. In this session, learn how to consider total cost; better understand how employees behave in CDHPs; and steps two employers have taken to maximize employee engagement and health improvements in their CDHPs.
ReThink: Health Care Providers are Engaging Patients Differently Too!
Representatives from Baptist Memorial Health Care, Methodist Healthcare, Regional One, Saint Francis Healthcare
For many of the same reasons employers are rethinking how they engage employees in their health and wellness programs, health care providers are also redesigning how they provide care and engage patients in their own health and health care. This session will highlight new delivery models being implemented by Baptist, Methodist, Regional One, and Saint Francis and the implications of these new approaches for your employee's health and wellness and the effectiveness of your health benefit plans.
Learn about our Keynote Speakers here
Learn about our 9:30 Breakout Sessions here
Click here to register for our 2016 Wellness & Health Benefits Conference "Rethink Employee Engagement to Drive Better Results" on August 18, 2016!
You will get to attend one of the following 9:30 breakout sessions. Start thinking about it now because they are all excellent and it will be a tough choice!
ReThink: Full Engagement: Harnessing the Power of Participation
Barbara McClanahan, PhD, EdD, Associate Professor, University of Memphis Health Promotion Program
Employees are often the most powerful advantage an organization has. However, the expertise, talents, insights, and creativity brought by individuals is quickly lost if the employee is not fully engaged with the organization. This interactive, audience participation session highlights the importance of participatory management practices and offers specific strategies to enhance your employee engagement in health benefits and wellness programs.
ReThink: Putting the Power Where it Belongs: With Employees
Cameron Brackett, Executive Director, MidSouth eHealth Alliance
Dinesh Sheth, Founder & CEO, Green Circle Health
The health care delivery system, and many benefits programs, make it easy for employees to be passive participants because the "power" is vested in the providers and programs. Employees become reactive vs. proactive managers of their own health. This session explores how technology can put the employee in charge of their own health information to track it, improve it, and share it with whom they choose, moving them from passive participants to active managers of health.
ReThink: Personalized Support When Your Employees Need it Most
John Dyson, Director of Human Resources, Enterprise Health Care, FedEx Services
David Hines, CEO, Consumer Medical
One-size fits all benefit and wellness programs fail to recognize that employees have specific health needs at different times throughout their lives. Online decision-support and outbound care management and coaching are often designed to meet the broadest set of needs and, therefore, may not effectively engage employees. This session highlights the benefits of offering personalized support for your employees and the impact on costs, quality of care, and employee satisfaction. Federal Express will share why they decided to offer such a program and the difference it has made for their employees and their benefit program performance.
Shelly, with Willis Towers Watson since 2003, provides thought leadership in global health and worker effectiveness and health and work performance research. including innovative engagement approaches that deliver optimal business value. Prior to joining Willis Towers Watson, she was Health and Productivity Leader for GE for 10 years.
Kim Stroud, Employee Benefits Manager for Manatee County, FL, our luncheon speaker, will share the story of how Manatee County has achieved a -2.3% health benefits trend since 2009. She will share the specific health benefit and wellness strategies they deployed that have resulted in employee engagement rates in the high 90%. Creative benefit designs, health plan and vendor collaborations, incentives, integrated clinical advocacy, and now an onsite clinic are just some of the pieces that have increased employee engagement and resulted in a negative trend.
Kim has served as Employee Benefits Manager for the past 10 years and was previously the Director of Health and Lifestyle Management for almost six years. Her Masters in Human Development Counseling certainly prepared her to develop a comprehensive program built on engagement and the stages of change. She is a frequent national speaker on how Manatee County has achieved savings and improvements in health without cost shifting to employees.
Memphis Business Group on Health is a coalition of member employers sharing solutions and providing tools to manage the cost and quality of health benefits in an ever-changing environment.
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