Employers and Providers: Strategic Opportunities and Partnerships

• Hear an employer discuss the advantages and disadvantages of a direct contracting relationship in its early stages
• Explore different risk allocation methods and their impact on providers, employers, and employees
• Analyze the role of plan design in supporting direct contracting arrangements
• Discuss the impact of different payment models on cost and outcomes: Understand how bundled payments can improve care coordination

PinnacleHealth is the leading health system in Central Pennsylvania. However, like many hospitals, it did not have any direct relationships with local employers until recently. In this session, learn about PinnacleHealth’s enlightening experience working with 100 organizations and their 100,000 covered lives through its innovative C.A.R.E.S. program.

Attendees hear about:

• The rationale behind PinnacleHealth’s decision to reach out to the business community
• Effective techniques to engage providers with employers: successful outreach initiatives
• Key elements of an employer’s health care needs assessment — collaboration among providers, employers, carriers, and brokers
• Critical first steps in partnering including the creation of pilot programs (bio-metric screening, HRA’s, narrow network products, and care gap)
• The benefits PinnacleHealth and local employers gained from establishing “permanent relationships” together

• Hear about steps to develop and grow opportunities with employers in a new provider business model
• collaborate with brokers and health plans to get a seat at the table with employers
• Shift the provider mindset to assessing the appropriateness of care
• Understand an incremental approach toward shared savings and risk

Understand how and why an employer switched from passively purchasing benefits to direct contracting for primary care, occupational health, wellness programs, and disease management. Metro Nashville Public Schools (MNPS) describes the strategic planning, operational considerations, and tools used to optimize outcomes for 13,200 active and retired employees and their families in five worksite primary care clinics.

The speakers discuss the results to-date and how MNPS and its partners:

• Secure buy-in from management and labor
• Gain acceptance from employees and their families
• Leverage employer and clinical data to identify opportunities, empower providers, and demonstrate outcomes
• Collaborate to innovate and drive outcomes
• Protect patient privacy

• Examine unique opportunities in direct to employer contracting
• Understand benefits of an employer-driven ACO model including:
• Increased patient safety and reduced hospital readmissions
• Enhanced member experience
• Improved patient-provider communications

• Tap into philanthropic partnerships to drive cultural change
• shift a community’s focus from a disease-based management approach to a health and wellness model
• Understand philanthropy as a catalyst to delivery system transformation
• hear how initiatives in Orange County help meet the Triple Aim

In this case study, a health system shares how it fostered trust with its local employer community and adjusted its value proposition with partners to build a new, growing business line. Attendees learn about strategic and tactical elements to improve provider-employer partnerships. Understand how Ministry Health:

• Dedicated personnel to collaborate with regional employers
• Leveraged existing employer partnerships to determine the most effective ways to impact overall health costs

• Understand development of an Employer Partnership Program at CTCA
• The role of the Gen 3 provider — enhance and fully leverage relationships with employers and payers by understanding and filling service gaps
• providers understand approaches to collaborate with payer partners to better serve employers
• employers explore how providers can help them design health and wellness programs and meet objectives