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Brokers, It’s Time to Put Quality Into the Conversation. Here’s Why

Somehow in the past decade or so, employers changed how they evaluated healthcare. PPOs became the norm, and the “quality” of the provider network was determined by its size. How many physicians and hospitals will my employees have access to if I go with this carrier? “More” became the yardstick for “better.”

Let’s think about that

The quantity of providers in a plan really has no correlation to the quality of the care it delivers. And when it comes to health, turning a blind eye to quality might not be the best idea. As Marty Makary, author of “Unaccountable,” writes, “The shocking truth is that some prestigious, large hospitals have four to five times the complication rates of other hospitals in the same city.” These days, employers are trying to wrap their heads around information like that, plus get a handle on costs that are going nowhere but up. Now more than ever, companies are open to new ways to solve ’s healthcare puzzle.

Information is power. Or is it?

Meanwhile, consumers are more empowered than ever. The technology in their pockets provides instant crowdsourced reviews. Apps like Yelp and TripAdvisor tell them which products and services are “best” — from the best pizza in town to the best four-star hotel in Rome.

But there’s a fundamental difference when it comes to their health: unlike a meal or a vacation, patients don’t necessarily choose to be consumers of healthcare. Even with a multitude of online lists, ratings and comments about physicians and hospitals, healthcare consumers are often ill-equipped to accurately analyze the cost and quality of the care they’re selecting. That leaves the employers who are paying for their plans holding the bag. They’re at the mercy of a healthcare system that’s more interested in selling broad access than in providing the information needed to make wise business decisions or to help employees navigate their options.

Customers need better data to make better decisions

A recent NEJM Catalyst survey asked healthcare stakeholders what needs to change to support consumers in lowering costs without compromising quality. The top response was that 71% want more transparency about the true cost and quality of services. It’s a simple approach that works for businesses in every other area of their finances — with good information around cost and quality, they’re able to make better decisions. It’s logical for healthcare too. Better decisions should lead to more controlled costs. The key is ensuring today’s consumers have access to that data, so that they can become better healthcare consumers.

For brokers, talking quality is a golden opportunity

What if you could frame conversations around the performance of a plan’s doctors and hospitals? What if you could talk about how the quality of providers affects costs? What if you could show customers a way to get information about quality that could help them make better choices about their healthcare?

You can with Imagine Health. Because we believe in a different yardstick. We’ve developed a methodology for more accurately calculating quality scoring of providers. It uses independent data to identify the best-performing physicians, health systems and hospitals. Not only that, we’re zeroing in on the systems, hospitals and physicians that measure up.

Why should quality matter to you?

With a focus on quality, Imagine Health is dramatically lowering costs for self-funded employer plans. Our selective approach allows us to partner directly with high-quality health systems and physicians in your community, locking in lower and more predictable costs in exchange for these direct partnerships on behalf of the employers. But more importantly, by building relationships with the best providers, we’re helping employees avoid the costly readmissions and complications that often come with lower-quality systems and doctors. Better health outcomes and lower costs, that’s a powerful combination.

What’s more, Imagine Health can help you show customers that you’re in their corner, that you’re a broker who’s thinking differently about one of their most pressing challenges: how to combine high-quality care with the lowest price.

Tips for quality conversations

When thinking about how health plan decisions impact quality of care, here are some ways you can talk about quality:

• Emphasize the relationship between higher-quality providers and decreased healthcare costs.
• Show clients performance data for providers in their specific market. Point out the variances that are meaningful when it comes to quality and price.
• Suggest that clients consider care navigation services. Empowered members can be more effective in self-managing their care. And care navigators can help steer them to the high-quality providers.
• Recommend health plan solutions that measure and assess quality providers.
• Bringing this topic into the mix may be easier than you think. It’s logical and it addresses your clients’ needs to take back control and lower costs. And you can call on a partner like Imagine Health to help. We’re focused on building affordable health plans for employers and brokers based on a quality-driven approach.

Read the white paper to learn more

Find out about our four-step approach for measuring the quality of care and how these metrics can be used to reduce costs by up to 30% for your customers. Plus learn more about how you can stand out by introducing quality into your customer conversations in our new white paper, “Taking Back Control of Healthcare Costs”