The SEHC has endorsed a value-based purchasing strategy for health care services. While cost remains a central part of the equation, quality of care and employee satisfaction are equally important. One of the most difficult obstacles to the full implementation of a value-based strategy is engaging the member as a consumer of health care. Many members do not recognize that the quality of care delivered in Maine varies considerably. In the absence of comparable measures, members select providers based upon reputation and the recommendations of family and friends.
Many employees confuse unfettered access to the providers of choice with quality.
In an effort to improve quality and to activate employees as consumers, a concerted campaign will be introduced to educate employees about the Institute of Medicine report on patient safety and medical errors. As a major purchaser of health care, the State employee plan must create the incentives for providers to deliver efficient, high quality care. In order to accomplish that, the State employee plan may alter benefit design for selected procedures based on outcomes and volume. Among the challenges facing the State employee plan are the need to activate consumers, the task of providing comparable quality measurements, and the development of methods to reward high quality providers. As a large purchaser of health care, the State employee plan must decide whether to merely react to an evolving health care delivery system or to become an agent for change using a value-based strategy as the guiding principle.