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I have often cited that employers, as the main purchasers of healthcare, sit on top of the supply chain and have the potential to lead the much-needed transformation of this market. While a number of substantive changes in this industry have come from Medicare, many improvements that have occurred in our public programs have been built on the learnings and innovations led by employers themselves. The historical list of employer-led innovation is long -- cost containment, managed care, quality measures (NCQA), hospital patient safety (The Leapfrog Group), population health, consumerism, etc.

But the job is far from done, and the issues have become even more urgent:

• Pricing inequities between charges to employers and those to public programs
• Global pricing inequities for drugs
• Continued lack of transparency across the system
• Lack of accountability for performance
• Industry consolidation that has led to further disfunction and with no reduction in waste and redundancy or improved interoperability

The time is now for a new generation of disruption and leadership from the employer community. And that is what is we are seeing as referenced by the recent article in Harvard Business Review by Walmart’s Lisa Woods, Geisinger Health System’s Dr. Jonathan Slotkin and colleagues – How Employers are Fixing Health Care and news of progress on Haven, the Amazon joint venture to revamp healthcare.

In the end, employers must act in concert, together, effecting change region by region while accelerating the ability to adapt those changes through a national framework. Our coalitions and the National Alliance can be great enablers of this next generation of employer healthcare leaders. While it’s not a new battle but the next generation of leaders is just getting started in taking it on and this change effort is essential!