- Our Members. We started with seven employers in 1990. Today, The Alliance has more than 240 employers and insurance trusts that continue to expand our reach in Wisconsin, Illinois and Iowa. Our members are engaged, thoughtful and committed to using self-funding to raise the quality and lower the cost of health care. By working together, they’ve been moving health care forward for a quarter century.
- Network Evolution. When The Alliance was founded, it relied on three Madison hospitals and four physician organizations for its provider network. Today, The Alliance network includes more than 80 hospitals, 7,000 medical doctors and 13,500 professional service providers. Each provider, large or small, strengthens the value of the network to Alliance members.
- Exploring Cost and Quality. The Alliance uses its connections and resources to educate employers and consumers alike about one of health care’s biggest secrets: high cost doesn’t necessarily mean high quality. Sometimes, the highest cost provider has the lowest quality. Sometimes, the highest quality provider has the lowest cost.
- Sharing What We Learn. The Alliance shares invaluable information about quality and cost in many different ways: educational events, employer communications, consumer tools and more. These efforts gained momentum in 1999 with the first QualityCounts report, which attracted national attention and built awareness about how consumers use cost and quality information. That eventually led to the introduction of the Find a Doctor website in 2014 to deliver information about cost and quality at the time when consumers are searching for doctors, hospitals or other services.
- Offering Cost Information. People who access care through The Alliance network can log in to Find a Doctor to compare the cost of more than 70 procedures. If cost information isn’t available from Find a Doctor, they can ask for a customized cost estimate by contacting The Alliance Customer Service Department at 800.223.4139.
- Creating a Path to Quality Care. When patients face serious surgery, the QualityPath program answers their key questions: What doctor should I use? And what hospital? QualityPath identifies doctor-and-hospital pairings that meet or exceed national quality standards and implement clinical processes shown to improve care. Participating employers agree to pay 100 percent of medical procedure costs and may add incentives for choosing QualityPath doctors and hospitals. That requirement is adapted for plans with health savings accounts (HSAs) to provide 100 percent coverage after the deductible is paid and offer the patient a cash incentive worth at least $1,000, which may be either funded in the HSA account or paid directly to the patient. Consumers benefit from high-quality care, lower out-of-pocket costs and the assistance of a patient experience manager.
- Better Ways to Engage Consumers. Engaging consumers with information about the quality and cost of health care is tricky business. That’s been proven by mounds of research reports and dozens of experiments. The Alliance is committed to examining what works and what doesn’t so it can offer better tools for reaching employees and family members. Sometimes, that means The Alliance plays a pivotal role in developing new tactics, such as Find a Doctor and QualityPath. The Alliance also seeks out opportunities to share information from experts in consumer education, such as becoming a Consumer Reports regional health partner. These efforts are always backed by access to live Customer Service representatives.
- Connecting Employers. Employers have ongoing opportunities to share information, compare approaches and refine ideas. Alliance Learning Circles regularly bring members together to hear from experts on employer health benefits, health quality, the Affordable Care Act, wellness and other issues. Annual Meetings focus on cooperative results, while Annual Seminars expand the audience to create a community forum on health issues. User groups explore special topics, from value-based benefits to onsite clinics. Our members are working together to solve one of our country’s biggest challenges: buying high-quality health care at a fair price.
- Coalition Collaboration. The Alliance believes working with other employer-focused organizations shares resources and extends our reach. The Alliance regularly participates in the National Business Coalition on Health, the American Benefits Council, the Midwest Business Group on Health and related organizations. Since 2001, The Alliance has repriced claims for the Fond du Lac Area Businesses on Health (FABOH), another Wisconsin coalition. The Alliance also works with other coalitions on initiatives that benefit everyone. For example, the Business Health Care Group, an employers’ coalition in southeastern Wisconsin, was a co-developer of the QualityPath initiative.
- Geographic Expansion. The Alliance has grown from its original base in Dane County and the surrounding area to cover Wisconsin, northern Illinois and Iowa’s Dubuque County. Continued geographic expansion is expected to steadily expand the cooperative’s reach so more employers can benefit from our innovative approach to self-funding.
- A Not-for-Profit Cooperative. The employers who participate in The Alliance experience the rewards of owning the cooperative. There is no middleman to profit from their health care spending. Instead, net income after expenses is channeled to cooperative members as “patronage,” as higher health savings, or both.
- Savings Keep Growing. In 2014, Alliance members achieved $35.14 in savings for every $1 spent for care in The Alliance network. That compares to $23.08 in 2005 and $4.29 in 1995. The Alliance aims to help members control the upward trend on spending, which is reflected by a per-employee, per-month cost increase that averaged 2.3 percent over a five-year period from 2010 to 2014.
- Paying for Performance. Since 2004, The Alliance has used performance-based reimbursement to reward providers for high quality care and better outcomes while creating incentives for improving performance. In 2014, 64 percent of all Alliance charges were part of a contract that offered incentives for better care.
- Giving Employers a Voice in Quality Measurement.The Alliance helps bring the employers’ point of view to quality initiatives through participation in the Wisconsin Collaborative on Healthcare Quality, the State Value Committee, the National Quality Forum and Measure Applications Partnership. The goal is to improve the quality of care.
- Valuable Partnerships with Preferred Pricing. The Alliance seeks preferred partner relationships that deliver meaningful benefits to members. Alliance members can access special pricing that includes:
- Stop-loss premium discounts from reinsurance carriers
- Dental, vision and prescription benefit coverage
- Flu shots and blood pressure screenings
- Travel/wrap and workers’ compensation networks.
- Discounts for employees at health clubs and fitness centers
- Insights and Tools. The Alliance blog offers insights into current health issues and developments. Employer toolkits help educate employees and family members about Find a Doctor and QualityPath. Information from Consumer Reports Health, the Choosing Wisely campaign and Consumer Reports Best Buy Drugs is actively distributed to employers and their employees. By serving as a conduit for reliable information, we’re helping consumers and employers alike understand that making better health decisions means more than just following the doctor’s orders when you’re sick.
- Real Data for Real Members. Employers who self-fund their health benefits want and need access to data about how their employees use health care. The Alliance offers reports and analysis that help employers analyze data for better decision-making, including an annual benefits survey that helps employers compare health benefits to regional benchmarks. The Alliance also supported the development of large data repositories that can be used to examine quality, safety and efficiency. Since 2005, The Alliance has worked with other health leaders in developing the Wisconsin Health Information Organization (WHIO), a statewide data mart for Wisconsin providers and systems
- Online, mobile and more. The cooperative works hard to maintain open communication channels for members, providers, partners and consumers. That means providing information online, making sure it’s mobile friendly and reaching out on social media. The goal is to use any appropriate channel to share information and reinforce relationships.
- Promoting Transparency. When health care is transparent, you can get answers to your health care questions. You can find out what health care costs, how good it is, what clinical processes are followed and what influences shape the process. The Find a Doctor website offers cost information at the time that consumers are searching for a doctor or health facility, which is when the information is likely to be most useful. The Alliance has won multiple quality awards for advocating for access to information that makes health care transparent for everyone who gets it, gives it or helps pay for it.
- Shaping Health Policy. Employers have an important perspective on state and federal regulations and legislation. The Alliance Health Policy Committee directs Alliance efforts to serve as an advocate for employers at the state and federal levels. A highlight in these efforts came when Alliance President and CEO Cheryl DeMars testified before the U.S. Senate’s Finance Committee in 2014 to introduce QualityPath and provide information about how employers address chronic conditions.
- Listening to the Marketplace. The Alliance actively reaches out to gather insights from multiple audiences. Ongoing member service visits help The Alliance monitor members’ needs and develop products and services. Employer advisory groups offer invaluable information in developing products and programs such as QualityPath. Every four years, The Alliance conducts Project 360 to gather comprehensive market research into the needs of employers, business partners and providers.
- Speaking Up for Patient Safety. Preventable medical errors continue to pose a significant threat to patient safety. In 2014, experts rated preventable medical errors as the third leading cause of death in the U.S., following only heart disease and cancer. The Alliance is a regional rollout partner for The Leapfrog Group, which promotes information on patient safety to consumers. The Leapfrog Group’s A to F ratings for hospital safety are shared on the Find a Doctor site.
- Linking Business Partners. Employers rely on a valuable network of services to use self-funding effectively. The Alliance works with 27 third-party administrators (TPAs), 128 agents/consultants and 61 agencies to provide information and support for their work with employers who are Alliance members.
- Relying on Member Leadership. A cooperative’s true strength is its members. Alliance members regularly step forward to share information and ideas, serve on panels and participate in pilot projects. The Alliance Board of Directors is comprised of volunteers drawn from member companies, providing vital leadership for the cooperative.
Blog: Helping employers offer the benefits needed to attract great employees
By Brad Olm
Vice President of Human Resources, Gordon Flesch Co.
Chair, Board of Directors for The Alliance
- Self-Funding Expertise. The Alliance focuses on helping employers succeed with self-funding. That gives us unique expertise in understanding employee data, using re-insurance effectively, implementing value-based benefit design and more. We have a deep understanding of opportunities and pitfalls because all our members rely on self-funding to deliver cost-effective health benefits for employees and family members.