Introducing the Iowa Health Buyers Alliance (IHBA)

The Iowa Health Buyers Alliance is an association of health care customers (consumers and purchasers) working together to promote wellness, a patient centered health system, improved quality, and increased transparency and public disclosure.

Our members include over 40 Iowa organizations which together represent more than 500,000 Iowans. They include public and private employers, labor organizations, consumer groups, the Iowa Medicaid Program, and other health care customers.

Our Mission

To improve health and health care quality, affordability, accessibly and transparency by:

• Promoting transparency and public reporting of health care provider performance using nationally recognized measures of quality, patient safety and cost.
• Publicly recognizing quality health care providers.
• Promoting better value through quality practices.
• Evaluating and measuring the performance of health plans and other vendors
• Supporting personal health status through health promotion methods.

IHBA work priorities

• Networking and relationship building, support from peers, and information exchange
• Increased influence through collective voice; organized voice of consumer and purchaser
• IHBA website, communications and reports/research
• Regional and statewide conference, membership meetings, and learning network events
• Free Consumers’ Health Guides and “Ask Your Doctor” cards
• Discount on patient advocacy program (s) such as MAP
• Access to health care data such as provider quality, patient safety and cost information
• Legislative advocacy
• Designated Community Leader by U.S. Dept of Health and Human Services and Regional Rollout Leader for The Leapfrog Group
• Member of the national Consumer-Purchaser Disclosure Project

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Membership and Supporters

Membership is open to public, private and non-profit organizations who by their nature are representative of customers and consumers of health care. These include cities, counties, State of Iowa, school districts, community colleges, multi-employee health and welfare plans, private employers and corporations, labor unions and others whose primary purpose is not the provision of health care insurance or health care services or products.

Organizations supporting the Iowa Health Buyers Alliance are the Labor Management Health Care Coalition of the Upper Midwest, the Health Policy Corporation of Iowa, and the Dubuque Area Labor Management Council.

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Operating Principles and Strategies

As a starting point the following apply:

1. Support better health care, better health, and better value as our shared goal.
2. Emphasize constant improvement as our shared culture.
3. Recognize that transparency of performance, price and other information is essential. Transparency has proven to be an important catalyst for change and improvement in healthcare. It is also essential for consumers and patients.
4. Advocate uniform adoption and public reporting of quality, patient safety and results measures through such organizations as the National Quality Forum (NQF), Center for Medicare and Medicaid (CMS), Agency for Health Research and Quality (AHRQ), the Leapfrog Group, the Consumer-Purchaser Disclosure Project, and the e-Value8 RFP and report.
5. Recognition, certification, and/or reward "best in class" health providers and use of Centers of Excellence. Pursue the Heart Value Partnership and similar programs.
6. Empower consumers with easy access to information. Publish the IHBA Consumers' Health Guide for Greater Iowa.
7. Pursue pharmacy program or approach(s) that creates transparency in the financial model and delivers the right drugs at the right time providing highest value.
8. Advocate prevention and healthy lifestyle.

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Working Relationship

To accomplish its mission the Iowa Health Buyers Alliance seeks to develop and support positive and effective working relationships with health care professionals and organizations, health insurance plans and other vendors consistent with the supply chain integration model. In all industries the suppliers are many times in the best position to articulate improvement strategies. This is believed to be especially true in health care. Thus, we will seek opportunities to work with and bring health professionals and organizations together to define approaches and areas of collaboration around aims for improvement, standards and specifications.

• Note: The Institute of Medicine describes the need to redesign the system to achieve the six (6) aims that will satisfy all of us. We support these aims.
• Safe: Freedom from accidental injury. To improve patient safety, health care organization and professionals must establish and improve systems that minimize the likelihood of error, make visible those errors that do occur, and prevent or mitigate harm from errors that reach the patient.
• Timely: The flow of care, free of undesired waits and delays for both those who receive care and those who give care. The process flows smoothly and waiting times are continually reduced for both patients and those who give care.
• Effective: The disciplined use of systemically-acquired knowledge to provide services that are likely to benefit patients and refrain from providing services not likely to benefit patients.
• Efficient: The continual reduction of waste in health care, especially waste stemming from errors and from overuse of ineffective tests, medications, procedures, technologies and other interventions. Waste includes any resource use that fails to help meet patients' needs, including materials, supplies, time, forms, measurements, reports, motion, duplicated efforts, ideas not used, and information that is lost.
• Equitable: The care of populations and individuals. At a population level, the goal of a health care system is to improve health status for all Americans and to do so in a manner that reduces disparities among particular subgroups. For individuals, the provision of health care services should be based on individual needs and not on personal characteristics unrelated to their health condition. In particular, the quality of care should not differ solely because of such characteristics as gender, race, ethnicity, income, education, disability, sexual orientation, or location of residence.
• Patient-Centered: Health care that respects and honors patients' individual wants, needs, and preferences, and that assures that individual patient's values guide all decisions.

Health care is both a private good and a public good since it is not just a commodity between private parties. Thus, these aims apply at the societal level as well as level of patients/consumers, purchasers, practitioners, and health care organizations. Performance measures and standards have and are being developed for each of the aims.

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Advisory Councils

Two supplier advisory councils have been identified to engage in dialogue and possible concerted action: one made up of health care providers and a second of health plan or insurance representatives.

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Why do Quality, Value and Transparency Count?

• Rand:Only 50% chance of getting the right care when visit the doctor's office.
• Institute of Medicine (IOM):98,000 preventable deaths in hospitals each year. In 2004 Health Grades reported this number to be 195,000 people, almost twice the number from the 1999 IOM report.
• Center for Health Transformation:You are 2,000 times more likely to die in the hospital from a mistake than in an airplane.
• The Leapfrog Group:The 1st three Leaps can save 58,300 preventable deaths, multiple times this # of disabilities, 522,000 medication errors, and at least $ 9.6 billion per year.
• Juan Institute/Midwest Business Group on Health:30%+ of health cost due to poor quality/ineffective care.
• Consumers Union:Every year, two million Americans develop infections while in the hospital and an estimated 90,000 die as a result. The remainder often endure prolonged hospital stays and sometimes suffer lasting health problems.
• John Toussaint, MD, CEO of ThedaCare:"About 70% of what we do is non-value-added (waste)." (Institute for Health Care Improvement (2-16-05). Note: Lean experts estimate 60% waste in health care.
• The Institute of Medicine:"Between the care we have and the care we could have lays not just a gap, but a chasm. The current care systems cannot do the job. Trying harder will not work. Changing the systems of care will." (Institute of Medicine's:  Crossing the Quality Chasm)

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