A new survey indicated that among large employers, many have not examined data on physician quality or shared health plan or physician data with employees that could help improve the value and quality of health benefits, according to a recent study in the Journal of the American Medical Association.
“Value-based purchasing has often been portrayed as the lynchpin to quality improvement in a market-based health care system. Under this paradigm as it was originally conceived, employers and other large purchasers of health care are expected to contract with health plans according to quality and cost. Other key elements of value-based purchasing include the promotion of quality improvement in negotiations with health plans and facilitating informed choice of health plan through dissemination of comparative cost and quality information to employees,” the authors wrote.
Although a small group of the largest national employers have been active in improving health care quality through the promotion of quality measurement, reporting, and pay for performance, it is unknown whether these ideas have significantly affected employer-sponsored health benefit purchasing.
Meredith B. Rosenthal, PhD, of the Harvard School of Public Health, Boston, and colleagues conducted a national survey of large employers regarding value-based purchasing of health care and related efforts to improve the quality of health care and employee health. The researchers interviewed by telephone executives at 609 of the largest employers across 41 U.S. markets between July 2005 and March 2006. The 41 randomly selected markets have at least 100,000 persons enrolled in health maintenance organizations, include approximately 91% of individuals enrolled in health maintenance organizations nationally, and represent roughly 78% of the U.S. metropolitan population. The 26 largest employers were identified in each market, with firms ranging in size from 60 to 250,000 employees.
A large percentage of surveyed executives reported that they examine health plan quality data (269 respondents; 65%), but few reported using it for performance rewards (49 respondents; 17%) or to influence employees (71 respondents; 23%). Physician quality information is less commonly examined (71 respondents; 16%) or used by employers to reward performance (8 respondents; 2%) or influence employee choice of providers (34 respondents; 8%).