Briefs and Resources
New Directions to Better Manage High-Cost Claims
High-cost claims have become the single fastest-growing healthcare cost for employers in the last decade. Since 2016, the number of health plan members with claims of $3 million or more has doubled, making these claims a significant threat to employer-sponsored healthcare. The elimination of annual and lifetime maximums through the Affordable Care Act has redefined what is possible.
Raising the Bar for High-Quality Mental Health
In a 2022 study by Gallup, nearly one-fifth of US workers (19%) rated their mental health as fair or poor; those workers reported about four times more unplanned absences due to poor mental health than their peers. Mental health issues in the US workforce cost the economy an estimated $185 billion annually in lost productivity and presenteeism. This Action Brief offers specific steps employers and other plan sponsors can take to raise the bar for high-quality mental healthcare to ensure a more equitable and responsive behavioral health system.
Fall Vaccinations Communication
Wondering how to Communicate with Employees About Fall Vaccines?
This two-page resource helps clear up confusion about respiratory virus prevention recommendations to help protect American families and businesses from disruptive surges in COVID-19, influenza, and RSV.
Prescription Drug Provisions in the Inflation Reduction Act of 2022
On August 16, 2022, President Biden signed into law the Inflation Reduction Act of 2022. This is an expansive piece of legislation and covers a very wide variety of policies. This Health Policy in Transit will briefly describe the provisions related to prescription drugs, specifically those that affect employer plan sponsors.
Supporting Employees with Cardiovascular Disease (CVD) through Aspirin Therapy
A recent study from the Patient-Centered Outcomes Research Institute (PCORI) reinforces the positive impact of aspirin, regardless of dose, in preventing heart attacks and strokes in people living with heart disease. This Action Brief equips employers with action steps to help employees with CVD make informed decisions about aspirin dosing.
Debunking COVID-19 Vaccine Myths
With the COVID-19 vaccine rollout in high gear, misinformation has flooded communication channels and led to widespread concern and vaccine hesitancy. Employers play a key role in debunking the abundant myths and reassuring employees and their families that deep research has proven the vaccines to be highly safe and effective.
COVID-19 Healthcare Impact – The Long View
Looking beyond the immediate concerns of COVID-19 vaccination and testing, this Action Brief revisits the potential long-term impact of the pandemic on employer baseline healthcare strategies. Recommendations for employers include how best to promote essential healthcare, implement benefits that fully integrate mental health care, and include telehealth options to remove care barriers.
COVID-19 and Immunizations
This Action Brief provides practical things employers can do to help guide employees through uncertain times to ensure widespread vaccine adoption.
What Makes Primary Care Advanced Primary Care
Advanced primary care (APC) delivers increased value for patients and purchasers by encompassing seven key attributes. Learn more about how APC leads to improved patient health, satisfaction and engagement; reduces unnecessary and emergency care; and has the potential to save 15% or more of overall healthcare spend.
Medical Imaging: Broadening the Focus to Include Cost and Value
Medical imaging accounts for 10% of healthcare spending — or $100 billion. Yet, with their laser focus on the cost of imaging, many employers and other healthcare purchasers have lost sight of the larger picture — value. Learn how to define and achieve value in medical imaging to ensure the best possible cost and quality outcomes for patients and purchasers.
High Value Preventive Care During COVID-19
Special focus on immunizations
Biosimilars in the Pharmacy Benefit
Despite the fact that less than 2% of the US population uses biologic drugs, they account for 26% of national prescription drug spending. Biosimilars can expand options, enhance affordability, and increase access to therapy.
Cannabis Products on the Formulary
Adhering to evidence-based and value-based standards.
Hospital Payment Strategies
Setting Price and Quality Expectations
Advancing the Employers Role in Healthcare Quality and Safety
Setting the Record Straight: The Urgency of Achieving Hospital Fair Price
Momentum at both the state and federal levels to make healthcare more transparent and affordable is growing. Efforts to achieve fair prices and transparency to lower the cost of healthcare that holds down wages and stalls business growth have been challenged every step of the way by hospitals. This resource identifies and debunks 10 of the top hospital industry inaccuracies around high, rapidly rising, and indefensible hospital prices.
Playbook: Prescription Digital Therapeutics
This Playbook provides an overview of the digital health space, including the emerging category of “Prescription Digital Therapeutics” (PDT’s) and the employer’s role in evaluating and implementing them.
Addressing Pharmacy Benefit Management Misalignment
High prescription drug costs continue to bankrupt families, put financial strain on businesses, and drag down the US economy and pharmacy benefit management plays a significant behind-the-scenes role. TO arm employers and other plan sponsors with a blueprint to understand and navigate PBM relationships and strengthen their negotiating and contracting capabilities, the National Alliance has developed this playbook for purchasers.
Employer Playbook on Biosimilars
Employers and other healthcare purchasers grapple with how best to integrate biologics into health and pharmacy benefit plans. The National Alliance has developed this playbook to provide clear information to inform conversations with health plans and other vendor partners.
Beyond Hospital Transparency – Getting to Fair Price
Hospital costs are one of the fastest-growing expenditures in the US economy, with employers and employees paying the highest prices in the world. This guidebook offers…
- An understanding of how to use the latest hospital price transparency tools.
- Insight into employer fiduciary rights and responsibilities.
- Actionable market- and policy-based strategies to drive value-based care
Behavioral Health Vendor Engagement Template
This Vendor Engagement Template (VET) supplements questions that may be included in ongoing mental health vendor management discussions. The goal is to help employers and other plan sponsors address issues of mental health access and quality, which are foundational to employer health strategy.