I was asked some very interesting questions; We are trying to better understand what an organization such as yours keys on when evaluating providers. Would you mind sharing what are the most important factors you use when evaluating healthcare providers?
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Here is my answer.
The key has been employer engagement at the top levels of leadership.
We are about cost containment. That comes about in four ways; negotiation on price, plan design, quality, and community improvement. We have been practicing value based purchasing from the beginning of the Coalition establishment.
Another unique thing about our employers is they do not use insurance carriers. They use TPAs and access a local provider network associated with the primary health system.
The last thing we want to hear is complaints. No matter how good the provider if we get complaints it won’t work.
We develop a plan design (VBID and VBBD) and a network to improve patient’s overall health. We want employees at work, safe and productive. The area of great savings is proper care using evidence based guidelines.
We know the physicians cannot do it all but teaming together; physician, employer and the hospital. We can build a medical community that supports the patient. Compliance with the care plan is crucial. The providers need to listen and work with us, as partners.
A main area of our RFP proposal evaluation is management and leadership style. We avoid vendor relationships that are inflexible and rigid. We want partnerships, with integrated management teams with common goals , frequent updates and adjusted targets.
We prefer long term agreements; 5 to 10 years, so we can establish goals and work on them.
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