Employers to CMS: Want to Do Bundles Right? Emulate Us

Philip Betbeze, October 26, 2017

Two business groups seek targeted deregulation and market-based purchasing strategies based on employer tactics they say have improved healthcare efficiency and effectiveness.

If the federal government wants better value for the healthcare dollars it spends, it should take a few lessons from the experience of large employers, say the representatives of two large employer associations that have banded together to advocate policy recommendations to improve value-based care.

Annette Guarisco Fildes
Annette Guarisco Fildes

The DRIVE Health Initiative, launched by the Pacific Business Group on Health (PBGH) and the ERISA Industry Committee (ERIC), is pushing President Trump and CMS to adopt value-based strategies large employers have undertaken in recent years to improve the quality and efficiency of their employees' healthcare.

Large employers' solutions have centered on value-based care principles, and while direct contracting and bundled payments for procedures have been effective for large employers in reducing costs and improving quality, their effectiveness on the health system has been limited because government schemes to improve value do not have consistent measures with those of the private sector, they say.

"DRIVE's primary purpose is to advocate for public policies that will improve quality and reduce costs based on innovations developed by private employers," says Annette Guarisco Fildes, ERIC's president and CEO.

DRIVE advocates six requirements for effective implementation of value-based care and a multitude of specific policy recommendations.

Bundled Payments

Before he resigned in the wake of the private plane travel scandal, former HHS Secretary Tom Price managed to torpedo several value-based programs initiated under the Obama administration.

Mandatory bundle programs were scaled back, and some were scrapped entirely because the Trump administration ostensibly wanted more freedom in their design, and principally, because it wanted participation to be voluntary.

Employers have had success with bundling, says Bill Kramer, executive director for national health policy with PBGH, even if providers have perhaps been less enthralled with the practice.

Philip Betbeze

Philip Betbeze is the senior leadership editor at HealthLeaders Media.

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