Reflections: The Alliance’s 20-year journey

Cathy Eddy, President, Health Plan Alliance

06/01/2016

Cathy K. Eddy, President
Health Plan Alliance
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The Health Plan Alliance is celebrating our 20th anniversary during 2016. The symbol for 20 years together is platinum, which is strong and enduring -- sounds like a good symbol for the network we’ve built together.

Since I helped to start the organization, I often feel like the Alliance historian. So this is my trip down memory lane sharing some of our milestones and accomplishments. We were incorporated in June 1996, as the HMO Alliance with nine shareholder members – eight health plans and VHA. Today only three of those original members remain – Physician Plus Insurance Corp and Sentara are the two health plans and VHA is now part of Vizient, Inc. What happened to the other six? Four health plans were sold or closed down, one dropped out and one went public.

I’m often asked how I came up with the idea for the Alliance. I didn’t. The genesis for the organization started with work that John Koster, MD, was doing on integrated delivery systems. I wanted to do something different and John was one of the people I talked to in early 1995. He said to give him 3-6 months and he would find something. The month after I moved to Dallas, he gave me a proposal to review on a group purchasing concept for health plans. We talked about it and I shared a Harvard Business Review article I’d read about Alliances by Rosabeth Moss Kanter.

In August, we pulled together the eight health plans and their owner systems to discuss if they wanted to work together and if so what they wanted to work on. During our two days together, the health plans identified 11 high priority areas and we got back together again in November to see what could be done in those areas. During the next meeting the group identified other health plans they wanted around the table, many of which didn’t have a VHA connection.

We set up the Alliance as a separate for-profit Limited Liability Corporation or LLC. Each of the founding eight plans contributed $50,000 in capital in early 1996 and became shareholders of the new organization. Our business plan projected a breakeven point within three years. The Alliance lost money in its first year of operation and then became profitable in 1997 and has been every year since then. The Board of Directors recommended building up a reserve of six months of operating expenses so we wouldn’t need to do a capital call in the future. By 2000, the Alliance was able to start paying out distributions to shareholders and two years later we added product distributions for all members. Since that first distribution, the Alliance has given back more than $9.3 million dollars to its members.

Initially we met with the CEOs and then added the Chief Medical Officers. Once a year we’d bring both together for a retreat. Our first retreat was held in Asheville, NC in August 1996 and our 2016 Fall Retreat will be in Monterey, CA in October. (link to event) We continued to broaden our reach over the years, expanding to C-level leadership and then further penetrating the health plan’s leadership and management teams.

After a 2001 meeting in Chicago, where a COO gave a great presentation on customer service we had a lot of requests to visit the plan to see the system in person. We asked ourselves two key questions:

Are we getting enough information about leading practices to our members to allow them to replicate these?
Are we getting the information to the right people in the plan?

These questions led to the formation of Value Visits in 2002 – probably our most popular activity we’ve done over the years. Our first four value visits focused on Customer Service, Medicare, Product Development and System Selection. Each of these sessions was hosted by a member health plan. The sharing that takes place in the dozen or so value visits we now do annually is open, practical, specific and very helpful to the participants. By listening to our members and their needs we are delivering the content that they want and need. We are often told that our members don’t get this type of open sharing anywhere else.

Our methods for sharing has expanded right along with available technology so that we now have over 100 webinars a year and 800 questions flowing via our emails, first through listservs and this month transitioning to the website with the kickoff of our community forums.

We also appreciate the loyalty of our Alliance members when they move to a new plan – so many of our new members join because they have an internal champion that has been involved with us at a prior health plan and wanted their new employer to become a part of the Alliance. We often get recommendations from our business partners and vendors, who promote the value of the Alliance to their customers. We now have 48 member health plans, but over the years we have served an additional 33 health plans.

In the 1990s, we had a lot of startup health plans and we originally supported them through meetings called the HMO Forum. Eventually, the Alliance added a “partner” member level and invited many of these smaller plans to join. In the past few years, we have been seeing a resurgence in the formation of provider-sponsored health plans and want to support as many of these as we can. The Medicare Advantage Collaborative started out as a way to support new and developing MA plans. However, the MAC ended up being the vehicle for expanded programming for all of our MA plans, serving more than 35 members.

With all the changes that came about with the Affordable Care Act, passed in March 2010, the Alliance has continued to be a vehicle for learning, sharing and growing. The public exchanges have been a focal point for a series of value visits and webinars focused on policy implications, product development, compliance challenges and technology platforms. Medicaid expansion and the development of offerings for duals have created additional opportunities for sharing.

As the insurance industry has continued to consolidate into several very large players, the independent and provider-sponsored health plans offer a regional alternative for about 1 in 10 individuals who are insured. Alliance members cover over 11 million lives. During the past 20 years, we have seen the development of integrated delivery systems continue to change. The movement to value-based reimbursement strengthens the reasons for a health care system to include a health plan. The integrated model that we work with needs the delivery system and the health plan to work together in many different ways for both to be successful. The intersection points of governance, care management, analytics, risk adjustment and information technology require commitment and collaboration within the IDS.

As the industry continues to evolve, the Alliance offers a unique gathering place to watch and support its members and their owner systems. As we mark this special anniversary, we want to sincerely thank all of you that have made it possible to share and learn together and we look forward to serving you in the years to come.

Happy 20th Anniversary to everyone who has contributed over the years to make the Health Plan Alliance a success.

Click here to watch our 20th anniversary video.

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