Realizing Effective and Affordable Change in Health Care
Health care spending growth targets for the 2023, 2024, and 2025 years were announced in a new report by the Midwest Health Initiative (MHI). The targets resulted from a partnership of nearly 30 St. Louis-based public and private employers, labor unions, health plans, health systems, and medical groups and will guide regional efforts to mitigate rising health care costs, while also monitoring advancements in primary care through a new quality measure set.
“This has been an important collaboration with a lot of discussion on affordability. It is vital for providers to understand the purchaser perspective,” stated J.C. McWilliams, Vice President of Managed Care for BJC HealthCare. “By having purchasers, health care providers, and health plans at the table, you have better insight. If you have better insight, you have better solutions. What I am most looking forward to is, together, peeling back the onion to focus on the cost drivers that are occurring in health care and the solutions that emerge."
In the summer of 2022, stakeholders began convening through a series of virtual workgroup meetings with the goal of Realizing Effective and Affordable Change in Health Care (REACH). Conversations were facilitated by three expert guides in economics, actuarial science, and state health care reform, including: Dr. Michael Chernew, Professor of Health Care Policy, Harvard Medical School; Mary Jo Condon, Principal Consultant, Freedman HealthCare; and Will Fox, Principal & Consulting Actuary, Milliman. The project was funded by a grant from the St. Louis Area Business Health Coalition (BHC).
“I have never been prouder of the health care community in St. Louis and their willingness to work with purchasers and plans to address the challenge of health care delivery cost and to achieve the best outcomes for our health care dollars,” said David Toben, BHC Board President and Director of Benefits for Bi-State Development. “We are setting a precedent for how a community of vested partners can come together and begin to make a real difference in the lives of our most important resource – the people who work hard every day at jobs across our region and who can no longer sustain ever-increasing health care costs.”
Considering broader economic trends and inflation projections, REACH workgroup participants used a Delphi-like process to achieve consensus on health care spending growth targets of 5% in 2023, 4% in 2024, and 4% in 2025. Spending will be measured in aggregate for the St. Louis commercially insured population and by individual medical groups across the region. Future public reporting will also demonstrate medical group progress in advancing primary care, including quality scores for prevention and screening, chronic care management, pediatric care, potentially avoidable/low-value care, behavioral health, and patient experience.
Looking ahead, Beverly Propst, MHI Board Chair and Senior Vice President of Human Resources for Graybar Electric Company, Inc., is optimistic about the ability to reach these shared goals. “The work will be hard, but with a foundation built on transparency, data insights, and commitments from our community partners, I am confident that these efforts will be successful!”