Mainebiz

W W W. M A I N E B I Z . B I Z 15 H E A LT H Y B U S I N E S S I n my position as the leader of a nonprofi t membership organiza- tion that works to improve the quality and lower the cost of health care, I fi nd myself in frequent conversations with employers from around the state about what they can do to wring more value out of their health care dollars. Whether it's the owner of a small business in Fort Kent or the CFO of a large company in Portland, everyone is worried about how they can keep their business running when health care costs are eating into larger and larger shares of profi t every year. Over the last decade we've seen fam- ily premiums shoot up nearly 50% in our state, while nationally they've risen nearly 60%. Traditional insurance plans are giving way to high deductibles and co-insurance and strapped benefi t pack- ages are putting Maine employers at a huge disadvantage when competing for top talent. As of 2014, Maine had the highest average deductible for individu- als with private, employer-sponsored insurance in the country at more than $700 above the U.S. average. e fi rst thing I tell executives is there's hope on the horizon, things are not nearly as bleak as they seem. Here in Maine we have something going for us that a lot of other states don't, and that something is a strong spirit of collaboration. e second thing I tell executives is that we need their help. So much of the problem with our health care sys- tem is that we're all operatin g in these silos that don't communicate with each other, and the result is a patchwork of fi xes for our system that never quite get us where we want to go. Employers need to be at the center of the con- versation. ey need to be in the same room as the providers and health plans asserting themselves. e message is simple: we need greater value for our health care spend and we need to work together to make that happen. ere are some private sector employers like e Jackson Laboratory and Bath Iron Works and public sector employers like the State Employees Health Benefi t program that really get this. ey've become engaged in a whole range of activities to control their health care costs while improv- ing quality and workforce health. ey sit on the board and attend meetings of the Maine Health Management Coalition's "Pathways to Excellence" committees, which vet measures of provider quality and cost for public reporting, and advocate for more trans- parency in our system. ey're actively engaged in worksite clinics, primary care, bundled payment and Accountable Care Organization arrangements with local health systems to explore alterna- tive delivery and payment models that incentivize patient health instead of increased utilization. ey're also put- ting robust wellness and prevention programs in place and taking advantage of our organization's health analytics. It may not be obvious to those that aren't engaged with this work on a daily basis, but already we've begun to make some real progress. Last year Maine became the second state in the country to begin publicly reporting on the total cost of care attributed to primary care practices and we partnered with Consumer Reports on a special Maine insert on physician quality perfor- mance, and we achieved agreement on a common measure set to begin assess- ing the performance of Accountable Care Organization arrangements. We also achieved agreement among multiple stakeholders to cap the annual growth in per capita health expenses in ACO arrangements to the regu- lar consumer price index rate and a common measure set to better assess ACO performance. We will issue a report this year with recommendations on how employers can move to value based insurance design strategies. ese are incremental steps on a long journey, I know, but they are sig- nifi cant ones. ey are proof that we can move the needle forward, and that together we can build a health care system that works for everyone. A W is president and CEO of Maine Health Manage- ment Coalition, an employer-led, multi-stakeholder collaborative. He can be reached at @ . Optimism on health care costs B Y A N D Y W E B B E R C O M M E N TA RY "Working with Landry/French on the construction of our new health center was one of the smoothest experiences I've ever had. They brought a high level of expertise, professionalism and teamwork to our project." — Tim Churchill, President, Stephens Memorial Hospital BUILDING ON TRUST Left to right: Kevin French (Landry/French Construction); Tim Churchill (Stephens Memorial Hospital) Whether it's a client we've worked with for years, or a new client who's undertaking their first project with Landry/French, our goal is always the same — to build a lasting relationship based on trust. With first-time client Western Maine Health, we earned their trust by delivering as promised on their new state-of- the-art medical office building. The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell The first thing I tell executives is there's executives is there's executives is there's executives is there's executives is there's executives is there's executives is there's executives is there's executives is there's executives is there's executives is there's executives is there's executives is there's hope on the horizon, things are not as bleak as they seem.

• Cover