Health Pillar Update

Chamber Outlines Health Care Policy Work

Denver Metro Chamber of Commerce members have consistently identified cost as the biggest concern regarding health care. This is likely because although Colorado is considered one of the healthiest states in the nation, we face high health care costs. This challenge impacts employees’ ability to sustain themselves and their families and affects a business’ competitive position in the current market.

Health and wellness has long been a policy pillar of the Chamber in recognition that having a healthy and productive workforce is a competitive economic advantage. We host a monthly health care committee meeting to increase members’ knowledge of health care trends, effective workplace wellness programs and policy and regulatory changes.  We’ve weighed in on countless legislative proposals and have supported studies to better understand how Colorado can curb the rate of growth in health care costs. In 2016, we convened a diverse coalition to defeat Amendment 69, a proposal that would have implemented government-run universal health coverage in Colorado through a massive tax increase on employees and employers and reorganization of health coverage.

Following the successful defeat of Amendment 69, Chamber members began asking how else we could engage in discussions on health care costs. In 2017, the Chamber convened a series of meetings among its health care members (i.e., carriers, hospitals, physicians, pharmaceutical companies and the bioscience industry – specific organizations listed at the end of this summary).  The purpose of these meetings was to address the factors driving up the cost of health care in Colorado and to identify potential actions to impact these factors.  The working group met for nearly a year and was guided by feedback obtained from a series of a dozen Chamber member focus groups that included members outside the health care industry.

Together, industry partners, non-industry business representatives and Chamber leadership and staff developed a series of recommendations to impact the cost of health care without negatively impacting quality.  The recommendations fall into one of five following categories. While some are legislative strategies, the vast majority are private market solutions:

  • Data collection, analysis and reporting
  • Transparency
  • Education, outreach and encouraging the use of best practices
  • Payment reform
  • Access and workforce

Data collection, analysis and reporting:
Among these categories, the group agreed that data collection and analysis is the keystone for all the other principles and related work. To better address the problem of high costs, we need to understand where high costs exist, cost outliers, whether cost relates to quality and how to develop acceptable payment standards. Our work here begins with increase in sharing data with the All Payer Claims Database (APCD), Colorado’s comprehensive database of health care claims information. Today, self-insured employers are not required to submit claims data to the database, resulting in missing information. We are encouraging self-insured employers to voluntarily submit their data to the database, allowing for better comparison data and a more complete data picture regarding health care payments in Colorado that could serve as the foundation for strategies like implementing payment reform, reducing practice variation and developing consistent statewide quality metrics and cost comparisons. If you are a self-insured employer (with an ERISA plan), please contact publicpolicy@denverchamber.org for more information about how you can share your data.

Transparency:
The group developed robust transparency and disclosure recommendations, understanding that they are key to analysis and consumer education. Our focus in this area is around pharmaceutical transparency and understanding manufacturing and marketing costs as well as the factors that influence certain price increases. This strategy is legislative in nature and we have expressed interest in working on a bill with health care industry partners and legislators. We are also hoping to work with industry partners to better understand pharmaceutical utilization and claims information.

Education, outreach and encouraging the use of best practices:
As a completely market-driven strategy, teaching consumers how to compare costs and quality effectively, discover how provider choice impacts costs and help businesses align with wellness and plan design best practices can help slow cost growth across the board and result in an even healthier workforce. A coordinated, market-driven strategy will be implemented and promoted to teach employers and consumers how to compare and use cost and quality data to inform decision making. Additionally, a statewide campaign will be launched focusing on cost reduction through appropriate utilization, a focus on disease prevention and smart health insurance plan design.

Payment reform:
Building on the foundation of data outlined earlier, payment reform was discussed among the group as a strategy for controlling cost growth. From value-based plan design and bundled payments to benchmark reimbursements tied to Medicare pricing, the group continues to explore different strategies to create a payment environment that rewards efficiency and quality.

Access and workforce:
Colorado is a geographically diverse state with varying levels of availability of care, which in turn impacts the overall cost and quality of care in those communities with less access to care. Increasing provider capacity can help improve health care in many rural communities, so we will be supportive of workforce development programs, the development of technology to enhance telemedicine and conversations about scope of practice to ensure Coloradans can access high-quality care for affordable prices.

Conclusion:
We are as motivated as ever as a business community to help solve some of our health care challenges. We know to successfully address cost in Colorado all components of the health care industry, as well as consumers ourselves, have to make changes. We go into this legislative session with energy and better understanding of how health care policy changes and market changes can influence heath care costs in our state.

Below is a list of industry partners who participated in our process. Being listed as a participant is not an indication that the organization supports each recommendation outlined in the Chamber’s report, but rather that their input and expertise was considered during its drafting. Health care industry partners engaged in this work:

  • Jandel Allen-Davis, Craig Hospital
  • Michael Cancro, UCHealth
  • Ana English, CIVHC
  • Michael Huotari, Rocky Mountain Health Plans
  • Trampas Hutches, Melissa Memorial Hospital
  • Brenda Gleason, Pfizer
  • Shannon Groves, Kaiser Permanente
  • Jennifer Jones, Colorado BioScience Association
  • David Keller, American Academy of Pediatrics
  • Dana Malick, PhRMA
  • Katherine Blair Mulready, Colorado Hospital Association
  • Dan O’Connell, UnitedHealth Group
  • Tamaan K. Osbourne-Roberts, Colorado Academy of Family Physicians
  • Dean Sanpei, Centura Health
  • Chet Seward, Colorado Medical Society
  • Sara Smith, HealthONE
  • Maureen Tarrant, HealthONE
  • Mark Spiecker, STAQ Pharma
  • Kathleen (Kiki) Traylor, Amgen
  • Rebecca Weiss, Anthem Blue Cross & Blue Shield