In early 2024, Morgan Health engaged X4 Health to conduct a series of interviews with self-insured employers – mostly covering more than 10,000 lives – to assess how they conceptualize health care quality and ways in which they can place a greater emphasis on quality through their benefit plan design.
What we found is that while employers are looking to understand the return on their investment across a number of domains, including for health outcomes, what they often find is a black box. Our topline learnings include:
- Outcomes-based performance guarantees are not common practice for employers. Including financial incentives for meeting clinical quality measures between employers and health plans or point solutions is not common practice. As a result, regardless of commitment to quality from benefits leaders, quality is not prioritized.
- Employers are eager for more “open source” learnings from other employers. Employers want access to best practices and case studies that provide details around health care quality innovations – what worked or what did not work. As employers explore new approaches to care and measure impact on quality, it’s time to talk about what “good” looks like.
- Data barriers are a challenge to developing an internal quality strategy Compiling medical claims across multiple sources is a challenge. Without a comprehensive data set, it is difficult to identify differences in quality and areas for improvement. As a result, employers can’t use a data-driven approach to identify opportunities for improvement or evaluate success.
- Provider-level quality data is not reliable or easily accessible to employees when they are making health care decisions. Objective measures of quality and cost are not readily available to employees to inform their choice of provider. Moreover, engaging employees around quality is complicated with conflicting incentives. Employers have limited tools, and as a result, there are a lack of strategies for employers to influence provider choice based on quality measures.
These findings underscore the critical importance of engaging employers to learn about their approaches to quality improvement and share best practices across the sector. By prioritizing health care quality, employers and their employees will all benefit from efforts to ensure that health care is safe, effective, patient-centered, timely, efficient and equitable.
