On Monday, the US Supreme Court began hearing arguments onthe future of the Obama Administration’s Patient Protection and Affordable Care Act (PPACA);a case that many believe will result in a historic health care decision.Although many Americans remain sharply divided on PPACA’s merits, there is no denying that health care in the United States is in need of reform.

In Virginia, employers of all sizes must maintain a competitive position and a productive workforce while also managing the added challenge of unsustainable increases in health care costs.Despite being the “best state for business,” Virginia is not the best state for health care. Our health quality indicators are only average to above average, with substantial variation within service sectors and across geographic regions. The health care value equation (conceptually defined as patient outcomes relative to dollars expended) is neither optimized nor sustainable for the long term.

In their role as purchasers of health coverage for more than 4.3 million patients , Virginia employers have a powerful opportunity to align the economic incentives in the health care system so that improvements in quality and value are rewarded. Government purchasers (including Medicare, Medicaid, and other programs) have the same opportunity, and obligation, to promote quality and value.

Governor McDonnellrecognized and prioritized this responsibility in August 2010, creating the Virginia Health Reform Initiative, and charging its 24 member Advisory Council with the creation of“an improved health system that is an economic driver for Virginia while allowing for more effective and efficient delivery of high quality health care at lower cost.“ He asked the Council to “develop recommendations about implementing health reform in Virginia, and to seek innovative solutions that meet the needs of Virginia’s citizens and its government in 2011 and beyond.”

See for example the Virginia Dashboard on Health Care Quality Compared to All States published by the Agency for Healthcare Research and Quality at http://statesnapshots.ahrq.gov/snaps10/dashboard.jsp?menuId=4&state=VA&level=0

See Kaiser State Health Facts at
http://www.statehealthfacts.org/profileind.jsp?cmprgn=1&cat=3&rgn=48&ind=125&sub=39

Johnson, S. “Governor Bob McDonnell Announces Members of the Virginia Health Reform Initiative Advisory Council” August 16, 2010, Available as Appendix A and from:http://www.hhr.virginia.gov/News/viewRelease

One promising solution is the creation of theVirginia Center for Health Innovation (VCHI).In establishing the new Center, its chair, Virginia Secretary of Health and Human Resources, William A. Hazel, Jr., MD, recognized that employer engagement in health reform and innovation is an essential element for success.
Incorporated in January 2012, VCHI is a non-profit, non-partisan, public-private partnership designed to accelerate the adoption of value-driven models of wellness and health care throughout Virginia.Unique in the nation, it provides a place where employers and government can work directly with providers and health plans on this aim, each with the ability to communicate their needs and expectations. Employers will have a major role on the VCHI’s board of directors and will be actively involved in establishing priorities for benchmark research, in the design of demonstration projects, and in spreading information about effective innovations. Working together through VCHI, educated and engaged employers can leverage their purchasing power to encourage the adoption of proven delivery system practices and payment reform.

This is certainly a new role for employers, and I predict it will be a game changer in health care. Employers have much to gain if this enterprise is successful. Innovation in health care, with a focus on improving value, conducted on a sizeable scale, should improve the health status of employees, lower both absenteeism and presenteeism, and yield higher productivity. It should also allow Virginia corporations to optimize their health care investments amidst increasing global competition and a challenging economic environment.

So as we wait for a verdict at the federal level, let’s not lose sight of this opportunity to simultaneously reform health care and better invest in business right here in Virginia.