Delivery and Payment Reform

Overview

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

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.

Delivery and Payment Reform Initiatives

Employers/purchasers are paying the bills for healthcare that is not delivering value. These initiatives support efforts to improve care and value.

Delivery and Payment Reform

Advanced Primary Care

Currently under-utilized, primary care has much to contribute to driving a more adaptable, streamlined, efficient system. And advanced primary care will improve even further the pathway to ongoing, coordinated, community-aligned, high-value care.
Delivery and Payment Reform

High-Cost Claims

The National Alliance is working to mitigate high-cost claims alongside employers/purchasers and other strategic partners. The goal is to define best practice strategies and determine effective benefit design for addressing high-cost claims while preserving access to optimal care.
Delivery and Payment Reform

Hospital Fair Price

High and rising hospital prices are largely the result of industry consolidation and the use of anti-competitive contracting practices to gain market power. Employers/purchasers are using their collective purchasing power to stem hospital spending growth by getting to a fair price.
Delivery and Payment Reform

Medical and Pharmacy Drug Management

All too often, pharmacy benefit managers (PBMs) and others across the medical and pharmacy drug management supply chain engage in opaque and anti-competitive business practices. Employers/purchasers are working to fundamentally reform PBM business practices and the drug supply chain.
Delivery and Payment Reform

The Path Forward for Mental Health and Substance Use

The Path Forward is a private sector approach to systematically and measurably improving five established best practices of mental health and substance use care.

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.

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