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.
- Health Policy Document
Delivery and Payment Reform Resources
- Health Policy Document
Insights from the National Alliance 2025 high-cost claims coalition workshops, along with the latest research, highlight the urgent need for employers to embrace data-driven, collaborative, prevention-focused strategies to address cardiometabolic […]
With drug spending a top concern for plan sponsors and costs rising, employers continue to explore new strategies to better manage spending. New “shared savings” vendors attempt to appeal to employers […]
With some biologic medicines topping $4 million for a single dose, specialty medicines now account for 46% of pharmaceutical spending—despite making up only 2% of prescriptions. Biosimilars, which deliver, on average, […]
- Health Policy Document
Download the full Health Policy in Transit document below to learn more.
Biosimilars are the future of specialty drug therapy, costing, on average, 50% less than their biological reference products, with some exceeding 90%. While adoption has been hindered by barriers such […]
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.