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by Paul Govern | Posted on Thursday, May. 9, 2013 — 8:25 AM
As the United States grapples with a combination of unsustainable growth in health care costs and comparatively lackluster overall population health, Vanderbilt and other leading employers in the region are seeking to improve the value of health care services for their health plan beneficiaries.
A new level of concern on the part of employers was evident at the latest semi-annual meeting of the Vanderbilt Employer Roundtable, May 2 at the Student Life Center. At the meeting it became clear that employers from the region very much expect to engage more directly with providers over the cost, quality and value of health care services.
The roundtable brings large self-insured employers from the region into a dialogue with each other and with senior leaders of Vanderbilt University Medical Center and the Vanderbilt Health Affiliated Network (VHAN). The focus is on employee health benefits strategy, delivery and management.
C. Wright Pinson, MBA, M.D., deputy vice chancellor for Health Affairs and CEO of the Vanderbilt Health System, said because Vanderbilt has some 50,000 health plan beneficiaries and is itself a health care provider, it brings a special perspective to the roundtable.
“Vanderbilt is not the solution, but we think we can be part of the solution,” Pinson told the group.
The meeting opened with a look at employer attitudes nationally and implications of health care reform provisions scheduled to go into effect for most companies in January 2014.
Large U.S. employers in general see themselves continuing to fund health benefits directly, rather than dropping coverage and instead paying new penalties.
They’re bullish about provider incentives for care quality and care coordination, and about new public investment in health care comparative effectiveness research. Surveys also show that large employers generally plan to remain self-insured for health benefits.
A theme of the discussion was that health promotion campaigns and other employer-led solutions are increasingly seen as a poor substitute for patient-provider engagement and more direct dialogue between employers and providers about ensuring standards of care and prevention.
A core selling point of the Vanderbilt Health Affiliated Network is better coordination of services across the continuum of care, supported by evidence-based practice standards and clinical information technology.
VHAN will reach out to employers to craft new solutions to improve the value of patient care, lower costs and ultimately improve beneficiary health status.
Mark Cianciolo, executive director of VHAN and of Corporate Health and Provider Network Development at VUMC, reviewed outcomes of Vanderbilt’s decision to partner with Cumberland Pediatric Alliance to develop and implement a care coordination program.
The program resulted in more appropriate utilization of pediatric primary care services, reducing Vanderbilt’s costs for beneficiaries who use these “tier one” network providers (costs have continued to rise for beneficiaries who seek care outside this tier).
As Cianciolo reviewed the VHAN story more broadly, it was apparent not only that the network will continue to grow but that it is open to trying new solutions to increase value for employers.
Backed by a national network of “second tier” providers, VHAN is now offered to area employers both as a self-insured plan and a fully insured plan. Both products are administered by Aetna.
Paul Govern, (615) 343-9654
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