Purchasing High Performance Archive

Purchasing High Performance is a bulletin for employers and others interested in promoting value in health care. It is produced in partnership with the National Business Coalition on Health.

Welcome to Purchasing High Performance
Welcome to the second issue of Purchasing High Performance, a publication designed for employers and coalitions seeking value in health care, and sponsored by the National Business Coalition on Health and The Commonwealth Fund.
80 Percent Agreement on Health Care Reform

In Washington, D.C., insiders know not to place any bets on pending legislation too early. When it comes to making law, the real work doesn't even start until bills are drafted and committees begin going through the details. Health care reform is now in this stage. Since June, all five of the Congressional committees charged with developing reform bills have done so. According to individuals on both sides of the aisle, the parties are in agreement on about 80 percent of what’s at issue.

What Is the Patient-Centered Medical Home?

Primary care physicians are a vanishing breed. A 2007 survey found that only about 2 percent of medical residents planned on making general medicine a career. The rest, presumably, will pursue careers in a specialty, where salaries are higher and workloads more bearable. If that doesn't bother you as an employer, it should—primary care physicians are the best value in medicine. In fact, employees who have a relationship with a primary care physician will cost you about one-third less than employees that don't.

Hitting the Copay Sweet Spot

Medical copayments—that is, the $5 to $30 you're charged every time you go to the doctor or fill a prescription—are not unlike certain drugs: effective, but often improperly used. It's no surprise, really. The science of designing and applying copays across different drugs, services, and populations is still part art.

Safeway Senior Vice President Ken Shachmut Talks about Holding Health Care Costs Steady, for Four Straight Years, Do-It-Yourself Health Reform, and $8,000 Colonoscopies

Working with Safeway CEO Steve Burd, Ken Shachmut is one of the architects of Safeway's much-talked-about health care reengineering program that has managed to do the remarkable: hold health care costs for the organization steady since 2005. President Obama frequently refers to the Safeway story as an example of what’s possible for the rest of the nation with the right approach to health reform. Here, Ken talks about what Safeway did and what's coming next.

What Does Rockford, Illinois Have to Teach the Country about Health Care?

More than 100 mostly small employers in Rockford, Ill. now participate in a demonstration project to test the Prometheus payment model, which promises to reward doctors and hospitals for delivering high-quality care. However, unlike many of the pay-for-performance efforts that preceded it, the rewards don’t accrue simply from delivering good outcomes, but rather from avoiding bad ones. The Prometheus model also promises to give employers the information necessary to fairly and productively negotiate reimbursement rates with providers.

Taming the #1 Cause of Disability Claims at Navistar, Inc.

The workplace has never been kind to the back or neck, which together account for about 18 percent of all workplace-related disability insurance claims. The extremities—fingers, toes, hands—also suffer the workplace poorly, accounting for another 9 percent of such claims. Humans may better adapt to the workplace in another few millennia, but in the meantime, employers may do well to follow the example of truck manufacturer Navistar, Inc., which saw a 45 percent reduction in per-claim cost at its Ohio manufacturing facility between 2004 and 2006. Their secret: talking to area doctors.

Need Help Selecting a Wellness Program?

A handful of wellness programs have earned accreditation recently from one of the two national organizations that offer related assessment programs: the National Committee for Quality Assurance (NCQA) and URAC.

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