Neil Goldfarb on the value-based impact of the Greater Philadelphia Business Alliance on health

Business alliances play an important role in driving value in healthcare, said Neil Goldfarb, president and CEO of Diabetes and GPBCH, in the 10 years since I launched the Greater Philadelphia Business Alliance for Health (GPBCH).

GPBCH will hold its 10th anniversary event on November 10, 2022.

Transcript

What prompted you to create a business alliance in the Greater Philadelphia area 10 years ago?

I am an academic researcher at Thomas Jefferson University and have spent most of my career in quality measurement and improvement and health economics. I am very interested in the following questions, what role can employers play or can play in driving healthcare value? I started researching with employers, thought leaders and other healthcare system stakeholders What do you think about this new value-based buying movement we’re hearing about? Do you think this will really drive meaningful improvements in the healthcare system?

Through these interviews, I became familiar with business alliances in other parts of the country that bring employers together to demand more value from the health care system. Unlike many other major metropolitan markets, Philadelphia has no healthy business alliances. So as I continued this research, I really came to believe that business alliances play a vital role in the healthcare system. In fact, my research shows that across all stakeholder groups working in healthcare, most KOLs believe that employers are best equipped to make change.

So, with that in mind, I left my position at Jefferson in hopes of building a healthy business alliance for the greater Philadelphia area. I just started knocking on doors, meeting with employers I met in my previous research, and getting some of the big early employers to agree with the idea. Wawa was the first to say, hey, if you do this, we’ll join. Comcast is close behind. When you have a name like that behind your back, other employers say maybe it’s doable, let’s try it. So, that’s really my motivation — businesses joining together can demand more of the healthcare system and use their buying power to drive improvements.

What has GPBCH achieved so far?

We announced in 2012 with 8 employer members and today we have 50 employer members. So, I am proud of it. It’s not something we intend to do in terms of changing the healthcare system, but I think it represents a success in terms of employers seeing the value of being united through alliances. So I’m proud of the fact that it’s grown 5x over the past 10 years.

I’m also proud of some of the work we’ve done. When we formed the coalition, the first thing I said to employers I met was, you know there’s a national movement called Leapfrog that’s trying to get hospitals to publicly disclose information about the quality of care and safety in their facilities? You know So, in our region, we have 55 hospitals, and only 3 of them voluntarily report this data to the Leapfrog team?

If we form a coalition, we can change that. We have the buying power, and we can ask hospitals to participate and set expectations that, as their customers, they use the Leapfrog tool to publicly disclose their safety information. So before we formed the alliance, 3 out of 55 hospitals were reporting Leapfrog data, and every year, that number was rising. We now report publicly on 78% of hospitals in the Greater Philadelphia area. This is an achievement.

Why it matters, why it’s not just a numbers game, we know that when data is published in the public space and available to buyers and consumers, it not only provides them with additional information to drive behavior, but also [incentivizes] Hospitals are investing more in their own quality and safety improvement efforts. We’ve heard directly from many of the providers who are now participating in the Leapfrog Hospitals survey, which helps them identify deficiencies in patient safety and address those deficiencies, and in some cases it actually lets them support them from the C-suite quality improvement plan.

So, we’re very proud of this because not only have we increased the transparency of patient safety, but we know that our patient safety has improved in many of these facilities because of public reporting. So, this is a major achievement that I am very proud of.

I think the other is in the area of ​​obesity and diabetes management. When we ask employers what is your biggest health challenge, obesity and diabetes are always number 1 and 2 on that list in some order.That’s right – 50% of the population is overweight and obese, more than 10% of the population [has] diabetes, and both proportions have grown over time.

Therefore, we have had great success in engaging employees in discussions to learn more about how to effectively support people at risk for diabetes, prediabetes, through efforts such as joining the CDC’s National Diabetes Prevention Program. I think we’ve had 15 employers now running the program for their employees, and they’ve all been successful in helping people reduce their risk of diabetes, mostly by losing weight. We also promote other things employers can do to support people with obesity or diabetes through benefit design and health plans, such as value-based insurance design, lowering copays and coinsurance for diabetes drugs and devices, or waiving copays all together.

We have successfully had several employers add anti-obesity drug coverage to their pharmacy benefit plans. It’s a topic I’m very passionate about: Employers treat obesity differently than other chronic diseases. They don’t even ask twice, should I be covered for antihypertensive drugs? Should I Cover Lipid Drugs? But they must be persuaded to cover obesity drugs.

So, I’m very proud that we’ve been breaking down the stigma surrounding obesity. It’s not just lifestyle, or lifestyle is clearly the main driver. It’s also genetics, and it’s also the built environment. So if we break down the stigma surrounding obesity and treat it as a chronic disease, we’ll see many employers focus more on what they can do to create equity and benefit for obesity, just as they do for many other common chronic diseases as done. So I’m very proud of several of the league’s achievements.

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