Which Door? | The "Which Door?" is a concept that involves a strategic approach to healthcare, aiming to achieve a zero trend in healthcare costs for employers. This approach combines clinical expertise, care pathways, and contract consulting to manage health risks and encourage people to engage with their own health. The pathway to zero trend is not just about cutting costs; it is also about improving health outcomes and creating a system of care that leads to sustainable long-term reductions in healthcare spending. Key components of the "pathway to zero trend" include: ● Data-driven decision-making: The first step is to distinguish between rumors and facts by obtaining objective data analysis from a third party. This helps employers understand the difference between best and worst performers on a risk-adjusted basis. ● Strategic Contracting: After understanding the data, employers should negotiate contracts that hold intermediaries and providers accountable for outcomes, with performance guarantees. ● Care Pathways: Implementing evidence-based care pathways is essential to manage current and future large claims. These pathways are not static but should be continuously improved based on new data and learnings. ● Integration of Clinical and Contractual Expertise: The approach combines clinical management of health risks and care pathways with expertise in contracting and plan design. This holistic approach creates a system of care that encourages engagement with individual health and reduces long-term costs. ● Transparency and Education: Transparency with consumers and employers about relative quality is important, and rewarding members who seek high-quality care can also be effective. ● Empowerment of HR teams: Providing support to HR teams by helping them feel confident, having the right tools, asking the right questions, and getting the right answers. This also means having the C-suite provide air cover for the changes that need to happen. ● Focus on trends: Rather than aiming for "zero" the focus is on achieving a "zero trend" which is more specific and clarifies the goal. This indicates that the focus is not on eliminating all costs, but rather stabilizing the rate of increase, or achieving a flat cost trajectory. The "pathway to zero trend" also involves a commitment to continuous improvement and a willingness to challenge established norms. It recognizes that change is not easy and that it may require overcoming resistance and established behavior patterns. It requires a value-based mindset that focuses on the why behind the change, making a case for it. This approach focuses on aligning the incentives of all stakeholders and creating a system where everyone is working towards the same goal. The idea is that this approach can be a journey of transformation, not just a strategy for cost savings. In short, the pathway to zero trend is about creating a sustainable, value-driven healthcare system where the focus is on both controlling costs and achieving better health outcomes.