Topsham nonprofit pivots to leverage large employers' health care clout
Courtesy / Healthcare Purchaser Alliance of Maine
Peter Hayes is the CEO of the Topsham-based Healthcare Purchaser Alliance of Maine. Formerly known as Maine Health Management Coalition, the nonprofit is changing its name and mission to elevate the buying power of large employers such as Bath Iron Works and Pine State Beverage as a way of improving health care and lowering its cost in Maine.
The Maine Health Management Coalition is changing its name and focus in a pivot intended to elevate the buying power of large employers such as Bath Iron Works and Pine State Beverage as a way of improving health care and lowering its cost.
Based in Topsham, the nonprofit announced in a news release this week its name has become the Healthcare Purchaser Alliance of Maine. The change is the result of a year-long evaluation of the organization’s mission and strategies that the alliance’s board of directors undertook in 2017.
“Previously focused on bringing cost and quality transparency to health care services in Maine, the alliance worked to help consumers and health care purchasers find and choose high-value doctors and hospitals,” the alliance stated. “While transparency remains a cornerstone of the organization’s mission, measurement and quality improvement activities alone are no longer sufficient. With costs for health care coverage and services continuing to rise at nearly twice the rate of inflation, the alliance’s board believes that health care purchasers need to be more strategic and proactive with the hundreds of millions of dollars they spend on health care services each year, using their considerable buying power to encourage and reward the provision of high-value health care services.”
The alliance has more than 50 members, including public and private employers, benefit trusts, hospitals, health plans, doctors and consumer groups working together to measure and report health care value. Members include Bath Iron Works, Bowdoin College, MEMIC, Maine Municipal Employees Health Trust, Pine State Beverage, The Jackson Laboratory, University of New England, MEA Benefits Trust and Verrill Dana.
To accompany the name change and shift in focus, the Healthcare Purchaser Alliance of Maine has launched a new website that includes information on specific strategies that health care purchasers can employ to control costs and improve quality for their employees.
Leveraging collective buying power
In its news release, the alliance said the new mission elevates the role of purchasers in Maine’s health care system and clarifies their intent to leverage their collective voice and buying power to lower costs and drive improvements in quality and access.
“A primary focus for the newly defined organization will be to move health care payment away from the current fee-for-service model that incentivizes more tests and procedures to a value-based payment model that rewards health outcomes,” the alliance stated. “This move mirrors the federal government’s focus on value-based care, and it is a model that health care purchasers around the country have seen success with in recent years.”
In its 2017 annual report, the alliance reports that in addition to its name change and new mission it also has moved to a purchaser-only board of directors.
Among the initiatives the alliance plans to roll out in 2018:
- Group purchasing of prescription drugs: The alliance stated in its annual report that at the beginning of 2018 it would make an Rx group purchasing program available to all members. “Results from other coalitions indicate that leveraging the purchasing power of multiple purchases and contracting with a transparent pharmacy benefit manager can generate substantial savings,” the alliance stated.
- Development of bundled payments and centers for excellence: The alliance plans to work with “willing Maine providers and payers” to develop what it calls “episode-based bundles of care to be purchased at centers of excellence.” Purchasers would be able to pay a bundled fee for all the services associated with an episode of care (for example, a knee replacement). “In markets where centers of excellence are being utilized, purchasers are realizing significant savings on the highest quality services,” the alliance stated.
- Incentivizing high-value sites of care: The alliance stated that for health services such as infusion therapy, urgent care and physical therapy, “there are dramatic differences in cost based on where the service is delivered.” It is working on identifying the “highest quality, most cost-efficient sites and services and to increase opportunities for purchasers to redirect members to such settings when clinically appropriate.”
“Health care purchasers have a key role to play in fixing our broken health care system,” said Michelle Probert, the alliance’s board chair and the manager of integrated health services at General Dynamics’ Bath Iron Works. “As the ones paying for more than half of the health care delivered in our state, there needs to be a seat at the table for purchasers alongside the hospitals, health plans and other stakeholders. Before the alliance underwent this transition, there was no organization in the state that was dedicated to advocating on our behalf and working to make sure our employees and their families receive the highest quality, affordable care.”
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