2004 NBCH Membership Profile
2004 NBCH Membership Inventory Report
About National Business Coalition on Health
The National Business Coalition on Health (NBCH) is a member organization of nearly 70 employer led coalitions across the United States. These coalitions represent over 10,000 employers-both large and small-who provide health care programs to millions of employees and their families. Composed of mostly mid and large size employers in both private and public sectors in diverse rural, urban, and regional markets, the Coalitions are committed to community health reform including an improvement in the value of health care provided through employer sponsored health plans.
- The National Business Group on Health (NBCH) with support from the Centers for Disease Control and Prevention conducted an inventory of its membership over a period of months in 2003-2004. The Inventory responses, 62 in total or 82% of the membership, were completed by web based response, FAX, and most by phone interviews. This process produced a richer result since more examples of the work of the coalitions was reported than could be captured by the inventory questions alone.
The questions were compiled based on the prior assessment with additional questions to gain a better understanding of the issues of each coalition, to identify initiatives in quality and measurement, to prioritize tools and information that would be useful for coalitions and their members, and to recognize the types of initiatives that coalitions are now doing or planning. The questions included service area and membership, quality and measure initiatives, project examples from the coalition members, and group purchasing initiatives as well as organizational structure.
Executive Summary
The 2004 membership survey confirms the variation in the coalitions as well as the common objectives to promote value based purchasing—quality and cost improvements in health care. The findings demonstrate the breadth of the activities of the coalitions as reported in the section on activities under a broad set of categories: joint purchasing, data reporting, prevention & wellness, provider quality, specific conditions such as cardiovascular disease and diabetes, consumer information & engagement, and other initiatives. The creativity and range of activities is shown in the 2004 report as well as information about the membership and organization of the coalitions including a sample of their employer members. Key findings show:
- The areas of greatest increase in interest by the coalitions include diabetes, blood pressure and cholesterol control as part of cardiovascular health, obesity, and lost work time.
- The most frequently identified method used by the coalitions to prioritize issues is their own membership, often by survey, followed by assessment using local data.
- Tools and information most needed include case studies of replicable employer examples especially that can be used to make the business case with the CFO and that demontrate cost effectiveness.
- The range of needs identified by the coalitions including support to address issues in rural markets, with smaller employers, evidence and information for chronic conditions and disease management, wellness, and effective quality improvement initiatives.
Coalition Overview
The following chart shows the number of coalitions in each of these size categories:
Number of Coalitions Reporting by Estimated Number of Employees, Covered Lives, and/or Retirees (not all responded to each category) N= 53 Not all coalitions reported in each category
| |
0-999 |
1,000-4,999 |
5,000-9,999 |
10,0000-24,999 |
25,0000-49,999 |
50,0000-250,000 |
250,000 + |
| Employees |
1.6% |
6.6% |
3.3% |
9.8% |
13.1% |
16.4% |
21.3% |
| Covered Lives |
0 |
1.6% |
1.6% |
6.6% |
8.2% |
32.8% |
29.5% |
| Retirees |
8.2% |
9.8% |
4.9% |
3.3% |
3.3% |
8.2% |
6.7% |
Small Group Purchasing Alliance
The number of coalitions currently with a small group purchasing alliance (defined as small employers from 2 to 100 or more employees) is 12. The number planning to have an alliance within 12 months is 14.
Quality and Measurement Initiatives
The number of coalition respondents with quality and measurement initiatives is (67%, n=41). Of those responding the percentage with efforts on measure use are as follows:
Use of Measures
| Category |
Financial Incentives |
Benchmarking |
Quality Improvement Activities |
Public Reporting |
| Health Plan Data |
4.9% |
24.6% |
24.6% |
29.5% |
| Hospital Data |
6.6% |
27.9% |
27.9% |
27.8% |
| Medical Group Data |
1.6% |
4.9% |
13.1% |
3.3% |
| Individual Practitioner Data |
1.6% |
8.2% |
8.2% |
1.6% |
| Community Health Assessment |
1.6% |
4.9% |
6.6% |
3.3% |
| Value Improvement or Outcome Projects |
3.3% |
13.1% |
14.6% |
3.3% |
| Public Reporting |
0 |
4.9% |
3.3% |
0 |
Other Measure Sources Identified: Leapfrog Group, Dartmouth Atlas, proprietary vendor measures/data, coalition centers of excellence project, Medicare hospital performance measures, Virginia State Patient Safety Coalition Survey Data, state-specific data
Types of Data Collected
| Category |
Health Plans |
Hospitals |
Medical Groups |
Individual Physicians |
| Consumer satisfaction or patient experience surveys |
24.6% |
18.0% |
6.7% |
8.2% |
| Outcome measures |
6.7% |
19.7% |
4.9% |
6.7% |
| Process measures |
18.0% |
19.7% |
9.8% |
8.2% |
| Cost or efficiency of care |
8.2% |
18.0% |
8.2% |
3.3% |
| Access to care |
11.5% |
4.9% |
3.3% |
1.6% |
|