National Alliance of Healthcare Purchaser Coalitions

The National Alliance of Healthcare Purchaser Coalitions (National Alliance) is the only nonprofit, purchaser-led organization with a national and regional structure dedicated to driving health and healthcare value across the country. Its members represent private and public sector, nonprofit and Taft-Hartley organizations, and more than 45 million Americans, spending over $300 billion annually on healthcare.

Building Trust for Industry Leadership and Engagement through RESET process

The National Alliance built trust and more candid engagement across key stakeholders by launching The Path Forward initiative to execute a disciplined, private sector approach to systematically and measurably improve five established best practices of mental health and substance use care. As part of the initiative, there are eight RESET Regions (Regional Employer Stakeholder Engagement Team) across the nation that were selected to implement its multi-stakeholder transformative process to improve access to and quality of mental health services. The RESET is engagement of regional stakeholders across multiple regional employer coalitions with national-level coordination and collective learning. By choosing an issue of great importance to employers and fostering an environment of employer leadership, shared mission, learning and collaboration, and a shared commitment to measurable improvement, RESET is a first-of-its-kind private sector approach to improve mental health and substance use care for Americans across the nation. How does this build trust? The National Alliance built trust by being transparent about its concerns and being willing to partner to deliver measurable improvements. This was further facilitated by focusing the national initiative on comprehensive and thoughtful evidenced based practices.

How It Works

The RESET process is focused on using employers collectively as the leaders of industry-wide change in areas critical to both purchasers and employees and their families. The National Alliance is composed of 45 regional employer coalitions across the country. RESET stands for Regional Employer Stakeholder Engagement Teams. The RESET process is being used to mobilize a five-point strategy for improving access to quality mental health and substance use services. The process includes:

Prioritizing the need and defining the broad objective
Researching the issues in the current environment
Developing and refining a collective agenda
Engaging and strategizing with key stakeholders to participate in shaping the action plan
Monitoring implementation

The Path Forward for Mental Health and Substance Use is led by collaborative diverse organizations representing professional societies (American Psychiatric Association, American Psychiatric Association Foundation Center for Workplace Mental Health), health policy (Meadows Mental Health Policy Institute) and employer plan sponsors (National Alliance, HR Policy Association). It is engaged with national and regional health plans, professional societies, accreditation organizations, and others. It leverages eight RESET Regions led by regional employer coalitions across the country that work with regional stakeholders on action plans to achieve measurable change.

Efforts are coordinated by a National Steering Committee where broader engagement occurs with national-level organizations. The process enables effective stakeholder collaboration at the regional and national level and learnings and issues are also shared among RESET Regions as the change process occurs.

Skills and Competencies

Depth in industry knowledge and perspective – Understanding the industry dynamics and the issues being faced by patients and purchasers
Visible and consistent communications – Being clear on the objectives, why they are critical and consistent in conveying such to a diverse audience
Transparency – Being willing to lead discussions on potential areas of conflict even in the face of relationship risk
Respect – Inviting and being able to listen to others’ points of view in order to consider all angles of concern
Focusing on measurable improvement – Working towards success collaboratively and with an orientation toward results and impact

Origins

The National Alliance in 2016 had reached a low in industry-wide trust. Stakeholders had been turned off by leadership that appeared arrogant, disrespectful to traditional stakeholder partners and oblivious to the complex dynamics in the industry. New leadership focused on rebuilding relationships and then working with employers and coalitions to define and prioritize key areas of focus. Strategic partnerships were developed in each of those key areas to help the National Alliance build out a more sophisticated and nuanced strategy. Discipline change practices were then coordinated with interested employer coalitions across the country with technical assistance from the National Alliance. Over the past four years, relationships have been rebuilt and the clarity of a collective agenda has emerged. As part of that collective agenda, the National Alliance defined serious deficiencies in access and quality of how mental health services are provided through health plans. A baseline was established through a deep dive assessment of these services through national health plans. This led to the collaboration with the sponsoring partners of The Path Forward.

Effectiveness

The evidence that we are building trust is the degree of industry engagement with our initiatives. The ability to influence change commensurate with our broader objectives is enhanced by the thoughtfulness and soundness of the recommendations and the willingness and ability of the stakeholders to engage in a respectful results-oriented process. Already, the level of engagement and support of the industry is leading to practical discussions on how these critical issues can be tackled and addressed. Furthermore, other leading industry players are looking to collaborate with The Path Forward including accreditation organizations Utilization Review Accreditation Commission (URAC, Joint Commission, National Committee for Quality Assurance), advocacy organizations (The National Action Alliance for Suicide Prevention) and leading consulting firms (Segal, Mercer, Towers Watson Wyatt, etc.). As importantly, the stakeholders at the regional meetings have found the process to be comprehensive, thoughtful and informed by leading evidenced based practices. Employers and these stakeholders are highly engaged to move The Path Forward forward.

Scalability

The principles and RESET process defined here can be applied to numerous issues and is being considered for other areas including addressing variations in care (e.g., inappropriate care), race, health and equity. Common to all of these areas is the need and advantages of employer leadership and the practical implications of having regional leadership and facilitation across the country. In the end, all health and healthcare are local, and the National Alliance is uniquely positioned to tackle complex issues with a disciplined change process built on relationship and trust.