The Companion Workbook to the Value Formula is designed to help you define your own implementation plan to unlock value in your health benefits plan.

There are two ways to complete the Workbook:

— Use the on-line version below and print it out

— Download the Workbook

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The Value Formula: Companion Workbook

The Value Formula

Companion Workbook

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Introduction: Putting the Value Formula to Work

Purpose of This Workbook: This workbook is a hands-on companion to The Value Formula: An Employer's Equation for a Healthcare Revolution. It is designed to help HR leaders, CFOs, benefits consultants, and executive teams apply the book's strategies in real-world settings.

How to Use This Workbook: This workbook is best used as an active tool. We recommend first reviewing the corresponding chapter in "The Value Formula" and then using these exercises individually to gather your thoughts, and subsequently in team settings or executive workshops to drive discussion, build alignment, and plan your actions. Remember that transforming your healthcare strategy is an iterative process; you may find yourselves revisiting sections of this workbook as your initiatives progress and evolve.

Discussion Questions

Where does your organization currently sit on the talent-cost spectrum?

How do workforce demographics influence your benefit priorities?

How important is it to reduce healthcare costs for you and your employees? (1-5) Key reasons for this rating:

Action Checklist

Map industry benchmarks on benefits vs. compensation and its evolution over time.
Assess volatility of your healthcare cost trend for the past 5 years, and parse the variance between price and use, and further by major service category.
Measure the impact of moving care to higher value physicians and facilities.

List your observations and implications:

Observation	Implications

Pros & Cons Table

Model	Strengths	Limitations	Fit for You?
Shared Savings
Bundled Payments
Capitation

Action Checklist

Rate readiness to pilot each APM model (1-5):

Shared Savings:

Bundled Payments:

Capitation:

Portion of total costs in each APM model (%):

Shared Savings: %

Bundled Payments: %

Capitation: %

Targets for plan costs in APMs (%):

1-Year: %

3-Year: %

5-Year: %

Key Gaps Identified in Administrator's APMs:

Action Plan for TPA Discussion:

Homework: Compliance with Federal Laws

Received broker attestation of all compensation.
Audited all contracts to ensure no gag clauses.
Documented a comprehensive fiduciary strategy for your health plan.
Verified machine-readable files (MRFs) are complete and accurate.

Homework: Consumer-Centered Transparency Checklist

Criteria	Key Gaps	Action Plan
Real-time, personalized out-of-pocket cost estimates available for all in-network providers’ services (before care is received)
Real-time, personalized out-of-pocket cost estimates for bundled payment/episode-based contracted rates by provider
Clear, understandable, tiered provider quality indicators (based on outcomes, safety, and patient experience) presented alongside cost
Integration with decision-making support (e.g., care navigation, concierge services) to help plan members select high-performing providers

Design Blueprint Template

Benefit Component	Traditional (Current)	Value-Based (Goal)	Key Steps	Timeline
Cost Sharing
Provider Access
Incentives
Chronic Care Support
Transparency Tools

Case Study Reflection

Which elements of the manufacturer's success are most applicable to your organization?

What are your biggest perceived barriers to implementing a similar approach?

Who are the key internal stakeholders needed to engage?

What steps can you take to improve:

Alternative Payment Model design in your current/future contracts?

Health Plan Benefit design to align with APMs?

How you measure and track outcomes (clinical, financial, patient experience)?

Key Trade-offs for Your Organization:

Mitigation Techniques Checklist (for HSA-qualified plans)

Meaningful front-load employer HSA contributions.
Linking wellness program bonuses/incentives to the use of high-performing providers.
Implementing post-deductible episode-of-care fixed copayments or coinsurance advantages for high-value providers.
Offering access to episode-of-care financing supports or medical credit options for pre-deductible expenses.
Leveraging IRS guidance to provide pre-deductible coverage for specified chronic condition medications/services.
Actively advocating for regulatory changes to allow more VBB flexibility within HSAs.
Offering a non-HSA, value-based plan option alongside the HDHP/HSA to provide employee choice.

Follow-up Action

For strategies not yet explored, identify one to investigate further in the next 60 days.

Strategy to Investigate	Assigned Owner	Deadline

Phase Summary Worksheet

Phase	Strategic Focus	Key Success Metrics
1	High-Value Networks & APM Pilots	% spend in APMs, COE utilization
2	Episode-Based Benefit Design & Consumer Engagement	Adoption of transparency tools, OOP cost predictability
3	Wellness Incentives & Whole Person Benefits Design	SDOH program engagement, specific health outcome improvements

Action Plan (Getting Started)

Thoroughly analyze your claims data.
Identify which providers your employees are currently using for high-volume/high-cost conditions.
Define key criteria for selecting partners for each phase.
Begin initial research or RFI process for potential partners.
Ensure that all of your APMs are structured as true risk contracts.
Incorporate the mitigation techniques from Chapter 5.

Vision Alignment Exercise

Activating and empowering employees as healthcare consumers: Current Alignment (1-5):

Improving trust between employees, the organization, and the system: Current Alignment (1-5):

Actively reshaping the care delivery market towards value: Current Alignment (1-5):

Follow-up Action: For areas with low alignment, brainstorm 1-2 initial steps to address them.

Call to Action Worksheet

Strategic Change	Internal Stakeholder	External Stakeholder

Self-Assessment: Value-Based Benefits Scorecard

	Initial Assessment	Follow-up Assessment
Date & Score
Key Areas of Improvement
Remaining Challenges

90-Day Action Plan Template

Week Range	Milestone	Responsible	KPIs	Status
Weeks 0–4
Weeks 5–12
Weeks 13–18

The Value Formula

Companion Workbook

Introduction: Putting the Value Formula to Work

Chapter 1: The Employer Dilemma

Discussion Questions

Action Checklist

List your observations and implications:

Chapter 2: Reimagining the Foundation (APMs)

Pros & Cons Table

Action Checklist

Chapter 3: Building a Transparency-Driven Market

Homework: Compliance with Federal Laws

Homework: Consumer-Centered Transparency Checklist

Chapter 4: Aligning Benefit Design with Payment Reform

Design Blueprint Template

Case Study Reflection

What steps can you take to improve:

Chapter 5: Navigating HSAs & Mitigation Strategy Selector

Mitigation Techniques Checklist (for HSA-qualified plans)

Follow-up Action

Chapter 6: The Roadmap

Phase Summary Worksheet

Action Plan (Getting Started)

Chapter 7: Driving the Future & Vision Alignment Exercise

Vision Alignment Exercise

Call to Action Worksheet

Self-Assessment: Value-Based Benefits Scorecard

90-Day Action Plan Template