RoadmapHealth Care
Quality Measurement
and Improvement
The employer-sponsored insurance (ESI) market is responsible for more than $1 trillion in health care spending annually, yet the value that employers, their employees, and their families receive remains unclear. Health care costs have been rising for decades, without commensurate improvements in health outcomes. And most employers don’t have specific quality initiatives in place, so they aren’t measuring quality improvement for their employees.
Our research suggests that the tide is changing. Employers are experimenting with new approaches to delivering health care to their employees—such as onsite clinics and accessible mental health care—they are looking to understand the return on their investment across a number of domains, including for health outcomes. While challenges remain to evaluate and pay for quality, employers can be a force for change in improving the quality of care for their employees.
Quality Measurement and Improvement Program
As a part of our mission to improve the quality, equity and affordability of employer-sponsored health care, Morgan Health is engaging employers to learn about their approaches to quality improvement and share best practices across the sector. By prioritizing quality, employers and their employees will all benefit from efforts to ensure that health care is safe, effective, patient-centered, timely, efficient and equitable.
We will do this by:
Testing
innovative quality solutions with the JP Morgan Chase benefits team
Convening
like-minded employers and ecosystem partners
Researching
the most effective approaches to quality improvement
Sharing
best practices and lessons openly with the ESI marketplace
Approach Our Three Pillars
Morgan Health, in collaboration with the JPMorgan Chase benefits team, is implementing a data-driven approach to quality measurement and improvement. Our core goals are to identify, prioritize and integrate quality measures centered around health improvement, access to care, effective chronic condition management, and reducing disparities.
Inform
Analyze medical claims joined with HR data (i.e., sex, age, income, race/ethnicity, etc.) to inform opportunities for improvement
Survey employees on health care and quality issues that matter to them
Educate employees about the importance of high quality health care and primary care
Support identification of providers who deliver high value and quality
Measure
Develop a measurement strategy to address short- and long-term goals (i.e., collect baseline data, identify ways to close equity gaps, etc.)
Pilot innovative measures that accommodate unique patterns in the ESI population (i.e., continuous enrollment, small numbers)
Identify effective measures that matter to employees (i.e., patient reported outcomes, whole-health measures, etc.)
Improve
Implement point solutions and programs in targeted geographies or sub-populations with opportunities for quality improvement
Drive accountability by including quality measures in direct contracts with providers, point solutions, and carriers
Negotiate risk-bearing or value-based contracts that tie payment to quality and health outcomes
