HRO Today July/August 2017 - 66

The Mercer Report
Organizations can
collect and integrate
detailed information
about healthcare
providers in their top
locations and tailor
it to their specific
needs. This data can
help organizations
understand where
opportunities exist
to lower cost and
improve quality.
[66]
HRO TODAY MAGAZINE
| JULY/AUGUST 2017
Broader healthcare issues about the metro area are
also factored in. For example, there is data around
whether there is an oversupply of hospital beds or an
undersupply of primary care physicians. Together, the
full range of data allows employers to quickly and easily
identify the locations where value-based care offers the
greatest potential.
The ultimate goal for organizations that take an ACO
approach is to align reimbursement with value not
volume. Employers can get started down this road by
committing to this pay-for-value action plan:
* Understand what percentage of the covered
workforce is being cared for by a provider with a
value-based reimbursement model, either through
access to ACOs or other incentives for high-quality care
and improved outcomes.
* Know how much the organization is paying in
additional fees for lives attributed to value-based
reimbursement models such as ACOs.
* Request carrier reporting that includes the expected
and actual impact of value-based reimbursement on
cost, quality, and member experience.
* Build this into carrier contracts and/or RFPs.
* Define a network strategy, establishing which local
and regional healthcare players can initially meet the
pay-for-value benchmarks.
Building from an action plan to a thorough data-analysis
approach will integrate the data on markets and
providers and make it actionable for employers. The key
is getting the right fit for the individual organization.
Over time, the result will be an employer-based
healthcare system that works for all organizations and
stakeholders-and value will be its clearest metric.
Molly Loftus is a chief actuary and partner in Mercer's health
consulting practice and specializes in value-based care strategies.

HRO Today July/August 2017

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