Coalition Releases Employer Guide To Managed Care
“Rising healthcare costs makes it even more imperative for employers to choose the right health plan for their employee population, based on the need to focus on healthcare value, which encompasses quality and cost,” Pat Montoya, executive director said. “The Coalition created this guide to provide employers with a quick reference to look at specific quality performance metrics. Employers chose the metrics so they could get a quick snapshot as to how the different plans are measuring up against each other, the state benchmark and national benchmarks.”
Employer coalition members continue to ask for transparency in health care both on quality and cost and this guide which is made available to members of the coalition can be one of the tools used when choosing health plans for their employees.
“The 2017 Employer Guide to Managed Care is the second edition of our guide, continuing the Coalition’s efforts to provide employers with the essential metrics to compare the health plans available in our community -- metrics that were not publicly available to employers in the community before the Coalition began this effort,” Montoya said. The Coalition’s first guide was published in 2016.
The 2017 guide is available in electronic and hard copy form. It is divided into easy, to read and understand sections providing comparisons of the health plans that give employers a quick look at the areas measured and overall how effective each of the participating health plans are at prevention, access, in-patient and outpatient utilization management, behavior health and patient satisfaction. Terms used in the healthcare and common definitions are included along with the latest data.
Blue Cross Blue Shield of New Mexico, New Mexico Health Connections, Presbyterian Health Plan and United Healthcare of New Mexico, all of who are members of the Coalition, supported this project and provided survey data. The data is reported using HEDIS®, a Healthcare Effectiveness Data and Information Set, that measures performance of care and service. The guide has data on several health issues and health plan member satisfaction.
“Today more than ever, employers are playing a critical role in the healthcare conversations. This guide provides some of the necessary data for employers to select the best plans for their employees’ needs,” she said.
The New Mexico Coalition for Healthcare Value is an employer-led, multi-stakeholder coalition working to improve health and maximize the value of healthcare services by focusing on the following components – quality, transparency and cost. Our mission at the New Mexico Coalition for Healthcare Value is to be an innovative force for creating the value of healthcare and we have a vision to have New Mexico as a national leader in healthy lifestyles and quality care. By producing this guide, we are moving one step closer to that goal.