New York Business Group on Health—Working with Public Health
Summary
The New York Business Group on Health has a long history of education and collaboration including a major initiative with the Mayor's Office in the development and ongoing management and administration of health insurance products for small business. The most recent NYBGH collaboration with the public sector is with the New York City Department of Health and Mental Hygiene to promote screening for depression by primary care practitioners. The Collaboration additionally includes the City, NY County Medical Society, NAMI-NYC, and all health plans in the area. The goal of the project is to increase the number of persons appropriately diagnosed and treated for depression.
About New York Business Group on Health
Founded in 1982, the New York Business Group on Health (NYBGH) is a not-for-profit coalition of 150 businesses and is the only organization in the New York Metropolitan area exclusively devoted to employer health benefit issues. NYBGH functions as the forum for businesses to explore contemporary healthcare issues and find practical resolutions. Members include employers and health-related organizations. The mission of NYBGH is to provide leadership and knowledge to employers to promote a value-based, market-driven healthcare system.
NYBGH addresses health issues through initiatives in quality, cost, access, education, and collaboration with the goal for cost effective quality healthcare in the tri state area. NYBGH on worked with the public sector through the NYC Mayor's office on the development of a set of health insurance options for small businesses in NYC as one major effort of joint collaboration.
New York Business Group on Health and Public Health
NYBGH has been a leading coalition in the use of eValue8 with its members. eValue8 is an evidence-based request for information tool to assess and manage the quality of health care vendors. The eValue8 tool uses a standard annual request for information survey to gather hundreds of benchmarks in critical areas such as adoption of health information technology, member and provider communications, disease management, program administration, provider performance, patient safety, pharmacy management, behavioral health and financial stability. The results from eValue8 showed a very low rate of identification of depression in the working population of its members compared to the overall work age population data. The analysis of claims data reported by individual NYBGH members — combining employer claims data for health, mental health, prescriptions, and lost work time related claims — showed a high rate of prescribing for selective serotonin reuptake inhibitors (SSRIs), class of antidepressants, as well as a high loss of productivity associated with mental health. The combination of this low rate of identification and diagnosis plus the high costs associated with mental health led to the creation of a NYBGH task force on Mental Health. NYBGH task forces are working groups of members who plan programs and activities for the entire membership.
The NYBGH Mental Health Task Force was formed as a response to the increasing awareness of the impact of mental health issues on employees' health and productivity. An initial focus of the Task Force is depression based on information gained through eValue8 and other sources that indicates that many people with depression are not being identified and are not getting appropriate treatment. The group's work in depression is focused on:
o Increasing awareness
o Decreasing stigma
o Promoting screening with consumers and physicians
o Advocating for appropriate referral and treatment
o Providing employers with information and resources to address the issue at the worksite
The NYC Department of Health and Hygiene had a campaign called "Take Care New York". "Take Care New York" is a comprehensive health policy that sets an agenda of ten (10) key areas for intervention. It recommends coordinated action on evidence based interventions by health care providers, city agencies, businesses, public/private partnerships, and individuals. The initiative included information about depression with encouragement for consumers with the questionhave you asked your doctor for a simple test for depression?The NYC Department effort included a public health campaign with the encouragement for patients to ask their physicians who in turn promoted the need for a common screening test to be used by physicians as part of their practice.
With the two complimentary projects, NYBGH invited public health members to their Task Force meeting. The discussion at that meeting with both groups led to a joint collaboration to focus on increasing screening for depression in primary care. NYBGH was able to get all the area health plans to participate. The current project is the "One Voice" initiative in which all the New York Metro health plans have agreed to collaborate on sending a single, common message to physicians promoting depression screening with the PHQ-9. This initiative is working in conjunction with the New York City Department of Health and Mental Hygiene's Depression Initiative.
The next step is to address the need to align reimbursement to promote this screening and treatment improvement. The City will also working with medical clinics that provide significant care to the Medicaid population. The NYBGH Executive Director, Laurel Pickering, is also a member of the NYC Department of Health and Mental Hygiene Advisory Council that advises the Commissioner of the Department.
Lessons Learned and Observations
o Lessons learned and observations from the coalition perspective include:
o Both employers and public health have common areas of interest
o Using common tools and measures—such as the same screening tool—across all stakeholders is an important factor in addressing the solution
o Employers can benefit from the common messaging and broad reach of public health communication campaigns
o Employers add to total health measurement (direct and indirect costs of both health care and productivity) to the public health perspective
o Coalitions can build on existing relationships (such as with the health plans) and past experience with other initiatives
o Value of public health engagement needs to be demonstrated to the employers
o Public health can benefit from the purchaser perspective and measurement approaches
o Coalitions and public health need to have effective ways to identify common areas of interest.
