Still an Optimist

This past week my daughter and I traveled to Washington DC.  I had business and she was on fall break, so it seemed like a good place to meet up, catch up and see some sights.

One of our rules of travel, no matter where we go, is that we do something we have never done before and that we learn a new piece of information we find particularly interesting, compelling or curious.  During this visit we saw the Martin Luther King monument, spent a day at the Newseum and took a private tour of the Woodrow Wilson House.  In addition, we just happened upon a Columbus Day event at the Library of Congress and saw the Stop the Machine protesters at the Freedom Plaza.   As is often the case, each activity evoked a conversation about history, politics and public policy.

I must admit, I was a relatively naïve activist when I was my daughters age (a college junior).  She is not.  She sees herself as a realist.  While she admires the courage and determination of the people memorialized at the different venues around town, she is not particularly optimistic that things can change for the better.  She questions the value of government, feeling that the huge bureaucracy as built can only fail. She wonders when new leaders will emerge and what events might actually get citizens to work together on issues of common good.  She is not sure that the collective voice of people without money and power can add value in creating a new vision and direction for the country.

I understand how she feels because I am often tempted to adopt the same attitude when I hear people talk about  “health care reform”. Can we really fix the health care crisis?  Can we even agree on what drives or defines the health care crisis?  Can we manage the multiple bureaucracies that seem so intent on maintaining the status quo?  Can anyone make a difference when the constraints of time and resources are so very limited?  Can a collective voice inform and influence a new course?

Through my work with the Buyers Health Care Action Group, I have had the good fortune of seeing, first hand, what a group of like-minded and motivated individuals can do when they work together.  I have seen leaders emerge with a vision for the future.  I have seen people engage in activities that precipitated significant change.  “Health care reform” again presents us with opportunities to rethink our current patterns of behavior, envision a better future and work with others to create a better way.  There is no better time than now, and no better way than together.

I hope my daughter has the same good fortune.

The power of personal connections

Bringing together public and private purchasers for more effective health care solutions

Recently, I received a phone call from one of the original founders of BHCAG who wanted to talk about something he read in the Star Tribune regarding health care reform. Since this is part of my job as president and CEO of BHCAG, this might not seem unusual or significant, but this particular conversation made me stop and think.

For starters, the person I was talking to was Fred Hamacher, who helped form BHCAG in 1988. Fred was a vice president of human resources at Dayton Hudson Corporation at the time, and he, along with others in similar positions at Honeywell, American Express, Carlson Companies, General Mills and Bemis (just to name a few) decided it was time to establish a coalition of like-minded companies that could influence and improve how health care was purchased and delivered. Fred has since retired but he stays active and interested - I would even go so far as to say, passionate - about high-value health care. Fred has been both a mentor and friend to me through the years, and any opportunity to connect with someone as visionary and influential as him is always a treat. But when that connection takes the form of a real, person-to-person conversation and not an email, all the better. Why? Because through conversations that allow for immediate reaction, disagreement or validation, transformative ideas are born and real problems are solved.

Driving more personal connections and collaboration

As I reflected on my discussion with Fred, I realized that my favorite part of working with BHCAG is the connection I get to have with people who care about the future. As sentimental as it might sound, caring and connecting are core to the BHCAG mission. All BHCAG members share their time and intelligence with one another to make the health care system work better for everyone. People who aren't passionate about this often don't invest the time in meeting with others to collaborate. I have to say, email, texting and social media truly do make daily life much easier in our time-constrained reality. But, as we have found recently, and what was affirmed in my discussion with Fred, nothing can compare to personal conversations and connections, particularly when you have a passion for something.

In January and February, BHCAG held several breakfast meetings with members to talk about health care reform, what’s important to them as employer purchasers, and what they want to see from BHCAG in the future.

We purposefully kept these groups very small and informal so each participant would have a chance to talk and listen and get to know one another. What I learned from these sessions is that our members really enjoyed being able to connect like this! I guess it seems like a luxury we can't afford ourselves because there is always too much to do and too little time to do it. Even our BHCAG programs over the years have become very focused on specific topics deemed critical to our members’ job functions so as not to "waste" people's time. Personal connection a waste of time? How did we get to such a place?

So, stay tuned. I am pretty sure we will be having more breakfasts with members in the months ahead.

Validation of BHCAG’s guiding principles and initiatives

What was also really important from my conversation with Fred was the reinforcement that the current concepts that are driving health care reform and making headlines today are the very same concepts on which BHCAG was founded and that we have been pursuing through our programming and initiatives for more than 20 years. Here are a few examples of how early BHCAG initiatives align with current health reform hot buttons:

• The call for increased oversight of, and accountability for health plans - BHCAG created the eValue8 survey as part of our effort to generate public reporting by health plans that is relevant to what purchasers want and need to know when making a health plan selection.


• The push toward accountable care organizations (ACO) - BHCAG developed what can be considered Minnesota’s first ACO with Choice Plus in the ‘90s. Choice Plus was the first program of its kind in the nation and BHCAG continues to provide counsel to organizations interested in advancing this type of initiative.


• The demand for improved patient safety - BHCAG was one of the founding members of the Leapfrog Group in 2000, and we continue to serve as the regional rollout coordinator for that organization’s annual survey of hospital patient safety outcomes.


• The need for improved patient outcomes - The Minnesota Bridges to Excellence program is managed by BHCAG. Launched in 2005, this program has contributed to an improvement in the delivery of optimal care for patients with diabetes, depression and vascular disease and is considered a national model for provider pay-for-performance programs.


• The need for purchasing principles - BHCAG was a founding member of the Smart Buy Alliance in 2004. The goal of the Smart Buy Alliance was to establish best practice purchasing principles for employer purchasers, and in turn to drive efficiency and improvements in care delivery.

What does this all mean to BHCAG as an organization? Well, for starters, it underscores that there is a market need for BHCAG and it demonstrates that what we do and provide is essential to changing health care in Minnesota. The fact that BHCAG initiatives and guiding principles are being validated at the legislative level means that we’re on the right track and that we can’t let up. The response that we’re hearing from members in our monthly breakfast meetings tells me that we must continue our commitment to these principles and to fostering conversations and collaboration among a wide variety of health care purchasers and stakeholders.

In the spirit of collaboration,

Carolyn Pare

President and CEO

Bringing it all together

Connecting public and private purchasers for more effective health care solutions

Aristotle knew what he was talking about when he penned the phrase, “The whole is greater than the sum of its parts.” In many aspects of life and business, we’ve learned that greater outcomes can be achieved when a group of people-or organizations-work together toward a common goal, with agreed upon parameters and metrics.

In health care, this sentiment has been proven time and time again. And it’s now more important than ever.

If we look historically at health care initiatives that failed when undertaken by an individual organization or entity, yet flourished as a collaborative effort with the proper industry expertise and guidance, it doesn’t take long to realize that we all benefit from a collaborative approach to health care. Minnesota is fortunate to have the type of business and health care environment that fosters and accepts collaboration as a key element of innovation. Consider the following examples:

• Payment reform-When BHCAG established the ChoicePlus product in 1992, it was with the intent to foster greater consumer choice, increased competition among providers, and improved quality. By uniting the interests of employers, health care providers, and individual consumers, we were able to develop a product that helped people make informed choices about where and how to spend their health care dollars. This initiative was so successful that the State of Minnesota adopted it as the model for its employee health plan. In addition, ChoicePlus was spun off and is now offered by one of the state’s leading health plans as part of their product portfolio. But the success of this initiative extends beyond of the borders of Minnesota, as tiered programs like ChoicePlus have become the foundation for consumer-directed health plans across the country.
• Patient outcomes-Minnesota Bridges to Excellence unites the clinical practices of physicians, the need to improve outcomes for patients with chronic conditions, and the broader public need for transparency around performance data. Providers who participate in Bridges to Excellence are helping to ensure that more Minnesotans receive optimal care for these conditions. Bridges to Excellence served as the basis for the Quality Care and Rewarding Excellence program launched by the State of Minnesota, as well as the public reporting structure adopted by the State.
• Patient safety-Patient safety should never be thought of as yesterday’s news. As one of the founding members of the Leapfrog Group, BHCAG has successfully worked with health care providers, employers, and legislative leaders to increase the public reporting of patient safety data and to educate consumers and employer purchasers on how to use this information when purchasing health care services.
• Health care data transparency and reporting-In all aspects of programming, BHCAG pushes for greater data transparency. For example, we bring together health care providers and legislative leaders to promote public reporting of outcomes and safety data. We convene employer purchasers, health plans and providers to address more cost-effective methods of reimbursing for care. And, we unite employer purchasers and health plans in an effort to promote health care consumerism through public reporting.

BHCAG has played a pivotal role in all of these initiatives-and in driving health care reform at a higher level. How? By uniting a broad spectrum of audiences-including public and private purchasers of health care, the medical community and political leaders-and connecting those individual interests to form a common goal.

To use a health care metaphor, BHCAG, like the connective tissue in our bodies, brings all the important players and functional areas in the health care and business community together to make health care work better. Because of BHCAG, and other employer collaboratives across the country, Minnesota has seen positive change in many aspects of health care.

As we look at the year ahead and the current state of health care reform, not to mention the still-slow-to-respond economy, purchasers will need to challenge conventional thinking and commit to working together to find solutions for some very complex issues. Changing a system that has been in place for decades and that is mired in broken processes that impact so many aspects of our economy will not be easy.

But, I have no doubt that if solutions are to come from anywhere, they will come from Minnesota. I look forward to working with BHCAG member organizations, the health care community, business leaders and political leaders in Minnesota and in Washington to meet health care reform challenges head on, and to demonstrate, once again, why Minnesota is a leader in health care and business innovation.

In the spirit of collaboration,

Carolyn Pare

President and CEO