Storytelling: Ken Horstman and Jon Schloemer
All employer members of The Action Group are invited to participate in Care Delivery Learning Networks to help drive needed marketplace change in the areas of overuse, cost and medical intervention variability. Learning Network involvement provides a unique opportunity to take a deep dive on specific issues, to collaborate with peers, and to meet face-to-face with health plans and providers to develop Employer Purchaser’s Guides.
To date, three Purchaser’s Guides have been developed: Back Pain and Surgery, Maternity and Infertility Care, and Total Joint Replacement.
Following the release of the Total Joint Replacement Purchaser’s Guide, Ken Horstman, senior director of total compensation at the University of Minnesota, and Jon Scholemer, VP of HR shared services at Fleet Farm, were asked to discuss their Learning Network experience at a member meeting.
Highlights of Ken’s Remarks:
- As the Learning Network progressed, it became clear that there’s a long road to an overall market solution. Some provider groups are much farther along than others, making for inconsistencies in cost and quality.
- We began to speak with health plans about providing incentives to employees to make the best provider choices.
- Joint replacements are a very profitable piece of business for care systems, so change is unlikely unless there is pressure from purchasers.
- There is such a complex web of various providers and locations, with some groups having as many as 80-90 surgeons, that making progress on bundling will take a collaborative effort.
- We are placing a reemphasis on the unique needs of each patient — and the fact that surgeons need to help them sort through the pros and cons.
- Employee education is key, with a focus on getting health plans to help bring to light the need to reduce overweight and obesity which may eliminate the need for surgery for some patients.
Highlights of Jon’s Remarks:
- Being a part of the Total Joint Replacement Care Delivery Learning Network gave me credibility with our employees. Armed with local, regional, national and global data, I am better able to help employees understand what to ask when they are considering treatments and surgery, how to figure out what’s considered good care, and about what needs to happen in recovery.
- The Learning Network meetings were all productive and enlightening.
- Because many of our employees are in rural areas, the variation in cost and quality is insane. We needed to understand the variations from cost and outcome standpoints.
- Most of our employees don’t really want to learn about health care and are uncomfortable with data. The Learning Network was a perfect place to learn about data that would actually influence decisions.
- This was my first Learning Network experience, and I knew immediately from the value statements that this was going to be a good experience.
- We don’t typically have time for special projects like those covered through the Learning Networks, so to have someone else arranging the meetings and keeping us on task was invaluable.
- The Action Group created a unique opportunity to interact with local and national experts and service providers and my peers to address some difficult issues.
“I would like to thank Ken and Jon for sharing their Learning Network experiences, and to invite all Action Group members to take part in our next one on the high cost of specialty medications,” says Carolyn Pare, Action Group president and CEO. “We like to say that, through The Action Group, we can do together what none of us could do alone. I am proud of the influence our Learning Networks are having, and how members are using the Purchaser’s Guides regularly in their work.”