In the early 1970s, the health care landscape of the Lehigh Valley was growing, becoming a three-hospital region and a system continuously adding services via the “fee for service” model.
As expenses increased for hospitals, so did the costs to businesses providing health insurance benefits to their employees.
In response, on Oct. 1, 1980, the CEOs of several of the region's largest companies formed one of the first business coalitions on health care in the nation – Lehigh Valley Business Coalition on Healthcare – to have a say and an impact in policy and legislation.
Through 35 years, the nonprofit coalition has grown from four member companies to 183, adding value-based health insurance group purchasing, health care benefits education and networking and performance assessment tools at hospitals and health insurance companies.
“They [business leaders] were concerned about some of the transitions occurring in the local health care market and how they would impact their business and employees,” said Tom Croyle, who became president of LVBCH in 2010 after nearly 35 years in the human resource department for subsidiaries of Allentown's PPL Corp. and 10 years as a board member of LVBCH.
LVBCH, on West Broad Street in downtown Bethlehem, and its member companies and organizations leverage their pooled purchasing power. That allows the coalition to design, negotiate and purchase health care plans through its partner vendors. Coalition members, in turn, select plans for their employees.
In addition to helping members reduce the cost of benefits, LVBCH also works with providers and insurers to improve the quality of care.
“The relationship that we are establishing with the provider and the community; it's what makes everything work,” Croyle said. “We're always driving and focusing on quality, affordable health care.
The founding goal of LVBCH was for the CEOs of the member companies to gain input into health care policy and to be more involved in how they could affect what the health care system would look like.
The coalition's original member companies are Air Products and Chemicals in Lower Macungie Township, Mack Trucks and PPL Corp. of Allentown and Follett Corp. of Forks Township.
“They [business leaders] wanted to have a business voice,” said Michael Donio, who worked as director of projects and member services for LVBCH for seven years. “To become a part of the public policy discussions that shape the size and construction of the medical care delivery system.”
In the mid-1970s, the only way the state received input on the community's needs was through federally mandated planning agencies that were formed, Donio said, but business leaders wanted to have a say, too.
“Systems kept expanding, but it wasn't responsive to the needs of the community,” said Donio, who previously worked for a health planning agency. “What it did, it created additional expenditures for the entire community who was now supporting three hospitals.”
By forming LVBCH, business leaders focused on making more of a presence at public meetings held by health planning agencies, to become more aware of the changes being proposed in the health care system of the Lehigh Valley.
With its largest member company at 18,000 employees and the smallest at two, LVBCH's members hail from 18 counties in Pennsylvania and five other states: New Jersey, Utah, California, Maryland and North Carolina.
As its membership began to grow, the coalition's business leaders thought it necessary to educate its 120,000 employee members on ways to best use their health care benefits for efficiency and effectiveness.
It began holding forums to exchange information, ideas and resources.
“As a member of the coalition for more than 25 years, Gross McGinley benefits from the excellent educational resources that the coalition provides,” said Deborah Faulkinberry, managing director for Gross McGinley LLP in Allentown, a law firm. “This education, along with the coalition's partnerships, has helped Gross McGinley reduce health care costs, without compromising quality.”
Working with partner vendors, in 1991 the coalition developed and launched its first self-funded, employer-designed health insurance product called Community Choice. The benefit package was a point-of-service plan that included medical, dental, prescription, vision and behavioral health services. Today, the coalition has a variety of companies and plans to choose from.
“Our organizations share the mutual goal of promoting high quality care while lowering costs, making this partnership a natural fit,” said Vicki Doule, senior director, group sales, major market at Capital BlueCross, a partner vendor for LVBCH. “The consumers and businesses of this region are fortunate to have such a strong and able health advocate like the LVBCH, and Capital BlueCross is fortunate to have a great partner in health.”
In addition to Capital BlueCross, LVBCH's partner vendors include Aetna, Cigna, Express Scripts, Integrated Behavioral Health, National Vision Administrators, United Concordia Dental, UnitedHealthcare and Valley Preferred.
“Our long-standing partnership with the Lehigh Valley Business Coalition on Healthcare is the result of a shared commitment to wellness,” said Tom Palmer, senior vice president of sales and service for United Concordia Dental. “The coalition is focused on helping Lehigh Valley employers – and their employees – make more informed decisions about their benefits and their health.”
LVBCH's next quest was to ensure employees were getting the most value for their health care dollar.
The coalition is a designated Leapfrog Group regional rollout organization, an assessment tool that works to increase transparency of the quality of hospitals. In 2010, LVBCH launched its first Leapfrog survey. Since then, Croyle said, the coalition has gotten most of the region's hospitals to participate in the scoring tool.
The scores from this assessment are a way for LVBCH employee members to get a closer look at where their health care dollars are going.
LVBCH then rolled out eValue8, a health plan performance evaluation and assessment tool by the National Business Coalition on Health, a national membership organization of purchaser-led health care coalitions. The tool is used to assess and manage the quality of the health care insurance vendors in the coalition.
“It's undoubtedly the most valuable organization you can belong to locally, if you are in the benefits business,” Bob Johnston, benefits manager at East Penn Manufacturing in Lyon Station, a more than 20-year member of LVBCH, said of the coalition.
LVBCH's employer membership has grown to include companies and organizations from various industries, including government, manufacturing, service, retail and education. Within the member companies, LVBCH's health care plans are for about 285,000 people.
An employer can become a member for as little as $100. Dues are variable, however, based on factors that include the company's number of employees.
One of the partners at Gross McGinley, Jack Gross, has been secretary of the coalition's 15-member board since 1999, serving as one of its only small-business board members.
“I have enjoyed working together with the larger employers on a wide variety of health care-related issues,” Gross said.
In looking ahead, Croyle said the coalition is delving into data collection. Last week the coalition signed a contract with Geneia, a Harrisburg-based health care technology and clinical solutions company, who will provide analytics for employer members to better manage the quality and cost of employee health care.
“We save employees millions of dollars every year,” Croyle said. “We are proud of what we do.”