Background: There is a need and readiness for collaboration between employers, health plans, and providers to overcome historic barriers (e.g., access to care, inequities in quality, care affordability) and help all move toward a more rapid adoption of proven and effective clinical practices. The COVID-19 environment has exposed a number of longstanding issues and highlights a unique opportunity to address complicated challenges such as health disparities, inequities in care delivery, inconsistent quality, waste, and unnecessary costs that jeopardize access and outcomes.
Proposed Solution to the Problem: With this in mind, the National Alliance, Alliance of Community Health Plans (ACHP), and University of Pittsburgh Medical Center have developed a healthcare collaborative partnership to develop a strategic action plan and collective roadmap/toolkit that shows how to improve coordination and information sharing across stakeholders to accelerate the transformation of care so that it prioritizes patients’ needs—and uses the healthcare system more efficiently.
Objectives: Strengthen the alignment and collective action of employers and healthcare purchasers, health plans, providers, patients, employees, and other stakeholders to realize improved overall health and well-being of the nation’s workforce. In addition, effectiveness research contributions can be achieved through the aims by highlighting where there are areas of opportunity to create an evidence base that focuses on how health care and other industries (e.g., employers, health plans) must work together to create truly patient-centered health. As clinical efficacy accounts for only about 20 percent of an outcome, this project will broaden the perspective of what overall effectiveness is and how it can be impacted significantly by non-healthcare influences; thus, PCOR and CER needs to accommodate the other influences on health.
Aim 1: Understand experiences, priorities, and intersections of employers, health plans, providers, and patients/employees, related to the development and use of evidence and best practices for achieving greater quality and value for stakeholders’ health care.
- Convene in-person/virtual multi-stakeholder advisory board meetings to:
- Examine each entity’s key drivers, core processes, and decision points related to what constitutes value-based health care
- Identify shared objectives and outcomes that shape how we collectively use evidence, define success, and utilize existing tools and resources
- Use a Delphi approach to seek consensus among relevant stakeholders (e.g., patients) about important quality, cost, and other patient-centered metrics related to healthcare quality and efficiency
Aim 2: Develop and disseminate a strategic action plan to all appropriate stakeholders that describes the roles employers, health plans, and provider networks can play in the uptake of clinical evidence; relevant outcomes/metrics to track progress and impact; and opportunities for comparative effectiveness research that informs optimization of health outcomes.
- Organize project team virtual meetings every four to six weeks to outline and draft the strategic action plan
- Convene an in-person/virtual multi-stakeholder advisory board meeting to:
- Review and obtain feedback on the draft strategic action plan
- Identify opportunities and define next steps for widespread dissemination
- Outline future collaborative research and dissemination opportunities among participating partners
- Develop a roadmap in the form of a toolkit for implementing the strategic action plan
- Identify key stakeholders that will drive adoption
- Clarify key action areas of focus
- Define measures/metrics that will determine success
- Identify elements of continuous improvement feedback loop to enhance future efforts
- Launch a public release and briefing event to present the strategic action plan and highlight real-world implementation examples through an accompanying whitepaper
Projected Outcomes and Outputs:
- A shared framework that demonstrates natural points of intersection around shared objectives and outcomes that reshape how we collectively use evidence, define outcomes, and use existing tools to improve healthcare quality, improve inequities in care delivery, cost, and experience.
- Aligned core objectives and an adaptable working framework for employers, payers, and employees/patients to utilize in framing PCOR-related collaboration—can be used by other stakeholder groups to advance translation and use of evidence to improve a shared set of stakeholder-driven, patient/employee-centered outcomes.
- A clear set of measurable outcomes that inform how cross-constituent stakeholders can improve employee/patient health and well-being.
- Prioritized areas for additional collaborative patient-centered outcomes research across stakeholders.
Patient and Stakeholder Engagement Plan: The project team recognizes the importance of stakeholder collaboration to improve efficiencies across stakeholder entities and strengthen the infrastructure and relationships necessary to more efficiently and effectively design a course of action to improve patient-centered outcomes. Therefore, the critical value of the Delphi process will bring real-world information that will support the development of the toolkit and will highly impact the set of measurable outcomes this project will deliver. Ultimately, the advisory board is the project’s oversight committee, responsible for assisting the healthcare collaborative by providing high-level feedback throughout the project lifecycle. The healthcare collaborative is responsible for day-to-day project functions, overseeing the conduct of the Delphi consensus generation activity, and convening and seeking feedback from the advisory board. The consistent feedback loop between the advisory board and healthcare collaborative will promote open communication, transparency, and collaborative development of project deliverables
- The National Alliance of Healthcare Purchaser Coalitions
- Alliance of Community Health Plans (ACHP)
- UPMC Center for High-Value Health Care
Margaret Rehayem, MA
National Alliance of Healthcare Purchaser Coalitions
Last updated: June 15, 2023