Delivery and Payment Reform
Key national initiatives to help drive momentum in healthcare delivery and payment reform include hospital fair price, medical and pharmacy drug management, high-cost claims, advanced primary care, and The Path Forward for Mental Health and Substance Use.
Delivery and Payment Reform Resources
- Case Study, Employee Resources, Final Report, Guidebook, Issue Brief, Placemat, Playbook, Toolkit, Vendor Engagement Template, Video
- Action Brief, Employee Resources, Issue Brief
Recent advancements in the screening, diagnosis, and treatment of kidney disease have created an unprecedented opportunity for employers and other plan sponsors to intervene earlier to delay or prevent progression […]
Employers/healthcare purchasers have a fiduciary responsibility to participants in their employee benefits plans to require their vendor partners to comply with the Mental Health Parity and Addiction Equity Act (MHPAEA), […]
The National Alliance PBM Misalignment Initiative investigates and addresses misalignment between employers and their pharmacy benefit management (PBM) service providers. Building on the 2023 PBM Playbook and other related resources, this final report […]
In this video, we explore how new data transparency highlights the crucial role hospital prices play in escalating healthcare spending, and why policy change, not reliance on health systems and […]
Coalitions In Action
Membership in the National Alliance is a catalyst for state and regional coalitions and their employer/purchaser members to advance key initiatives. Together, they leverage their collective influence to drive health, equity and value.
The Alliance
Reference-Based Contracting by The Alliance® uses Medicare as a benchmark for fair pricing instead of focusing on a discount off billed charges. Its bargaining power and employer-ownership model help negotiate better prices than large PPOs. On average, Wisconsin healthcare payers pay 307% of Medicare; The Alliance contracts at 175-275%.
Delivery and Payment Reform
Advancing Value-based Care
The US healthcare system has a longstanding reputation for high costs, poor health outcomes (compared to other developed nations that spend much less), inequities, waste, and inefficiency. The National Alliance Delivery and Payment Reform Committee is continuously pursuing opportunities to improve care, patient experience, and outcomes while lowering costs.