HBHI is the host of 'Conversations on the Business of Health,' a series of one-hour webinars that engage leaders of business and academia about improving American health care. Here are some highlights from the recent discussion about high-value employee health care with President and CEO of the Purchaser Group on Health, Elizabeth Mitchell, and CEO of Morgan Health, Dan Mendelson. The conversation was moderated by HBHI’s Joanne Kenen, who is the Commonwealth Fund Journalist in Residence at the Bloomberg School of Public Health.
Around 150 million Americans rely on employers for access to health care. Can the companies who employ them help foster an affordable system that improves our health and doesn't drive us crazy in the process?
“Healthcare is wildly complex and it's not their day jobs. They build airplanes and computers and yet they are expected to somehow fix U.S. healthcare,” said Elizabeth Mitchell, President and CEO of the Purchaser Business Group on Health. This membership organization, which includes “jumbo” employers like Walmart, Microsoft, and Salesforce as well as public purchasers like CalPERS, collectively represents the health needs of 21 million Americans.
“We have a lot of opportunities to use our leverage to make the system more accountable,” said Mitchell. “Policymakers haven't always understood that.”
One jumbo employer that’s independently investing in new systems of care is JPMorgan Chase, a company with 285,000 employees and dependents in the U.S. that spends about $1.7 billion each year on health care. Increasing patient affordability, care quality, and health equity are three main goals of their investments in new models.
“Our mission is to drive innovation in employer-sponsored health care,” said Dan Mendelson, CEO of Morgan Health. His business unit oversees an allocation of $250 million from the JPMorgan Chase balance sheet to invest in companies that are effective catalysts for change in health care.
In a recent HBHI webinar, Mitchell and Mendelson shared important trends from the world of business that have the potential to align corporate incentives with the broader public goals of eliminating disparities and improving whole person health:
Workers may be remote, but health care is still local.
“One of the things that I think we've come to understand is that if you spend too much time trying to drive national consistency, you lose out on the idea that healthcare really is local and that you're ultimately working with a provider in your own geography,” said Mitchell.
Purchaser incentives are broken.
“I would love to see the benefits teams of the largest corporations in America be aligned with quality improvement and the kinds of things that patients care about,” said Mendelson. “Let's pay our HR professionals more when we improve diabetes, care for high blood pressure better, increase mammographic screening.”
Self-insured employers are leading the way.
“These employers are the only ones, other than Americans and their families themselves, who have the incentive to reduce costs and improve quality,” said Mitchell. “Are we actually noticing our employees who are at risk for a C-section who shouldn't have one?” added Mendelson. “I think it's really incumbent for us to deal with this. We have food insecurity in Fortune 100 companies that we also have to deal with. It's really all of these issues that self-insured employers need to tackle over the coming years.”
Primary care is key to improving every indicator.
“Data shows employees with a primary care relationship have health costs 30% less than those that don't. Their health is better, their outcomes are better, and they are just healthier. That is a win-win,” said Mitchell. “If we can get them attached to a primary care practice and then using only the highest quality specialty practices, they know that that's better care at lower cost. So, we are working very actively with multiple partners to try to make this happen across the country.”
Technology matters.
“When we survey our employees, particularly those under the age of 40, they have a very core expectation that there's going to be outstanding digital functionality,” said Mendelson. “Not only with respect to visiting providers, doctors, nurses, pharmacists, others, but also with respect to being able to have choice models that are layered in there. We think that artificial intelligence has a lot of potential to better patient selection of providers that are appropriate for them, particularly in encompassing patient preferences.”
Data sharing will unlock innovation.
“We've all had experiences of actually trying to get information out of the system for ourselves and our loved ones. The providers have not taken seriously their obligation to make that information readily accessible to consumers. I think that's a real problem that reverberates really through the system,” said Mendelson.
“This is a business model problem because we've got data systems that don't talk to each other by design so that they maintain their proprietary special whatever, but it's not in the interest of patients and it's not in the interest of families who are trying to find the best care,” said Mitchell.
As companies like JPMorgan Chase and other corporate giants explore new ways of improving health that will trickle down to smaller employers, pharmacy benefit managers and those who profit off the status quo won’t be feeling especially comfortable.
“Are we at a tipping point? I think we are. It will challenge the incumbents. Yet that's what we have to do because the system right now is not working,” said Mitchell. “We're working together in new ways, and it's going to take all of us.”
Go deeper on this topic with HBHI’s 'Conversations on the Business of Health' webinar from Sept. 30. Watch it here.
