The National Business Coalition on Health: Independently Assessing PBM Value for Employers

According to John Miller, executive director, MidAtlantic Business Group on Health, The National Business Coalition on Health (NBCH) is an organization that seeks to drive conversations about prescription drug benefit management (PBM) to value. Utilizing an evidence-based, comprehensive assessment called ValuePort, NBCH helps employers consider the value PBMs provide in quality (rather than cost alone).

The members and coalitions in NBCH aim to develop programs that underline their 4 pillars of value-based purchasing. Those four pillars include: “standardizing performance measurement, reporting performance measurement results publicly, reforming the health care delivery payment system, and engaging consumers in informed decision making.”

NBCH’s assessment, a subset of their other program eValue8, promotes quality and transparency by incorporating services such as URAC and NCQA accreditations into its measurements. eValue8 is NBCH’s “flagship” vendor management tool that is used by employers to measure vendor performance. Valueport builds on eValue8’s offerings by including performance comparisons and rankings, as well as raising plan sponsor expectations. It is hoped that these quality measures will help providers and vendors to better understand data and to implement strategies that will improve health outcomes.

Miller suggests that their assessment focuses on population health, cultural competencies such as ethnicity and geography, and patient engagement. While not a consumer-based service, Miller says it’s important for stakeholders to get involved with “wise decision making” as close to the consumer as possible. This is especially true for management of conditions such as diabetes and obesity.

Coalitions who participated in a pilot program of ValuePort found that there were opportunities for more meaningful engagement with employers, access to training and skill development of useful data analysis, and an ability to observe other coalitions’ best practices and approaches to value-based purchasing.

The ValuePort assessment will be used by the NBCH’s 60 coalitions and will reach approximately 7,000 employers. Miller suggests that other PBMs can benefit in collaborating with employers.