David Merrill and John Robinson Discuss Barriers to APMs, Factors of Interest

The ability to have a plan that’s going to work and be large enough that it makes sense for those involved is a barrier for employers who want to pursue alternative payment models, said David Merrill, HR benefits manager, Volusia County, Florida and John Robinson, CEBS, REBC, RHU, president and CEO, RobinsonBush.

Transcript (slightly modified)

What are some barriers that exist for employers who want to pursue alternative payment models, and what needs to be done to overcome these challenges?

Robinson: I think it’s just the ability to start and have a plan that’s going to work and be a plan that is going to be large enough that it makes sense from the care perspective, from the group that is participating in it, and also from the provider perspective.

Merrill: I think it’s really important to our employees too, so that they’re able to get the care that they really need and they don’t know about. So, we need to educate them on these thing, and make it easier when they’re diagnosed and going through that process, cancer treatment.

What are some factors that determine an employer’s interest in being involved in an alternative payment model?

Merrill: One of the big things with the county is that we’re self-insured and we have probably around 6000 members and we have about 450 retirees in our program, and our average age is probably around 47- or 48-years-old right now, which is pretty much the norm in Florida for county government. So, we’re an aging workforce, and that’s usually when these type of things start to crop up.

Robinson: I think it’s the value. Looking at the alternative payment model from the perspective of if an employer sees the value in it, then it’s something they will pursue and look at. Employers will spend the money in order to have the level of value. It doesn’t; necessarily have to be the cheapest type of care. It has to be something that’s effective and efficient and for the benefit of the employee going through that particular treatment, and also that provider as well, and the employer.