Accomplishments

The Employer Provider Interface Council (EPC) has emerged as a DIVISION providing key stakeholder strategic decision support as the Employer Provider Council (EPC) of the Hospital Quality Foundation (HQF).

Since its founding in 2018 as the Employer Provider Interface Council, the Employer Provider Council (EPC) has actively been engaged in unique educational activities (both virtual and live), and provided expert insights from real-world research or commercial data sources to facilitate change in commercial marketplace health plans.

Highlights

  • Marketplace “Lay of the Land” regarding employer-based medical versus pharmacy benefit coverage and trends  (Amicus 2023)
  • Health Benefit Trends (Pre-/Post-Covid) with Spotlight on Benefit Trends in Obesity Management, Including New Transformative Rx Treatment (Eversana / Novo Nordisk 2022)
  • Annual Women’s Health Benchmarking Survey with a Spotlight on OC’s and Low-Dose Options (Eversana / Abbvie 2022)
  • EPIC Survey(s) / Report on Annual Benefits Coverage Survey – 1st Annual survey publication content on key women’s health and fertility benefit coverage  (Ferring 2022)
  • Designing Outcome-Based Agreements with Virtually Integrated Health Systems  (AstraZeneca 2021, Virtual Advisory Board)
  • EPIC Advisory Board – Testing key messaging for employer coverage decisions (Cyan Health 2021)
  • Employer Forum on Evidence-based Decision Making in the Management of Depression: Impacts on Outcomes and Employer Metrics (Orexo 2020)
  • Evidence-Based Decision-Making in the Pain Management of Post-Surgical Procedures: Impacts on Outcomes and Employer Metrics (Pacira 2020)
  • AADC Deficiency Provider-Employer Summit:  Evidence-Based Decision Making for the Treatment of AADC Deficiency and Impacts on Outcomes and Employer Metrics (Agilis 2018)
  • Helsinn Oncology Digest: CRITICAL ANALYSES OF NOVEL CANCER ECONOMICS, PRACTICES AND TECHNOLOGIES (CANCEPTS)  (Helsinn 2018)
  • Mobility as a Framework for Managing Osteoarthritis in a Holistic Chronic Disease Model (Sanofi 2017)

Collaborations for Change and Innovation

Employers as an ad hoc group, Business Groups or Coalitions

  • Individual, state-wide, regional, nationa
    • Obesity management and benefit guidelines on coverage
    • Oncology care
    • Womens’ health care
    • Vaccination and preventative care

Clinical societies or associations

  • Optimization of patient care in oncology
    • Newsletter
    • Conference and workshop collaborations
    • Advisory group participation

Healthcare provider administrators, Insurers and benefit advisors or third party management groups

  • Timelines for benefit design decision making and employer priorities
  • Successful collaboration planning and execution

Manufacturers

  • Timelines for benefit design decision-making and employer priorities
  • Women’s health
  • Digital therapeutics

Health insurance and legal groups

  • Strategy support
  • Insights on benefit trends in the marketplace for select therapeutic categories
  • Risk management

Education and Insights

Access to highly qualified individuals with experience and expertise examples:

  • Oncology, Cardiology, Endocrinology, Gastrointestinal, Ear Nose Throat, and other specialties including hospitalists
  • On-site, near-site, and direct primary care for employers
  • Benefits design and coverage policy
  • Holistic care and integrated benefits strategy

Benefit insights and expertise examples:

  • Insights on benefit trends in the marketplace for select categories
    • Women’s Health
    • Digital therapeutics
    • Rare disease, cell and gene therapies
  • Benefits and practice change or innovation
  • Value-based care or contracting

Benefits-related resources developed and provided

  • Obesity management and benefit guidelines on coverage
    • (virtual conferences, strategy support)
  • Oncology care newsletter, strategy support
  • Insights on benefit trends in the marketplace for select categories
    • Women’s Health
      • (virtual conferences, strategy support)
    • Digital therapeutics
      • (decision analytics tool, articles, virtual conferences, and implementation pilot support)
    • Oncology, biologics, Rare disease, cell and gene therapies
      • (articles, live workshops, or virtual conferences)
      • Innovation development and consensus building
      • Strategy support
  • Decision analytics tool for value-based decision-making by employer plan sponsors