National Alliance of Healthcare Purchaser Coalitions’ Annual Forum Focuses on PBMs, Obesity, Affordability, and Medical Debt

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KHC staff attended the National Alliance of Healthcare Purchaser Coalitions’ Annual Forum in November 2023. The Forum is an opportunity to collaborate with other coalition staff from across the country and to learn from thought-leaders in the healthcare space on trends, issues, and opportunities facing employers and communities throughout the healthcare system. The Forum included several key discussions and learnings that are relatable to KHC’s Kentucky and Southern Indiana communities. The Forum also marked another year of participation on the board by KHC President and CEO, Jenny Goins. Additionally, the National Alliance welcomed it’s new President and CEO, Shawn Gremminger, and wished a happy retirement to outgoing CEO, Mike Thompson.

Annual Forum Key Learnings

Pharmacy Benefit Managers (PBMs)

The Commissioner of the Federal Trade Commission, Alaro Bedoya, addressed questions and concerns he has related to PBMs. These questions include policies and procedures related to mail order, steering practices, PBM consultants, and span/breadth of PBM networks. He also addressed his concern and need to focus on inner city and rural communities. While he didn’t share answers to the questions, many of these questions are areas of concern for KHC employers and community members.


Panelists representing medical, pharmaceutical, consultant, employer and coalition organizations addressed the obesity epidemic facing the United States. With an obesity rate greater than 40% in Kentucky, this epidemic is very much a concern and a strategic focus for the KHC. As far back as 2013, the American Medical Association (AMA) recognized obesity as a chronic disease. Several interesting points made by the panelists included the fact that genetics plays a 20% to 80% role in the chronic disease of obesity. David Hines, Executive Director for Benefits, Metro Nashville Public Schools, shared information from five years of data he has collected on obesity from his health plan membership. With his extensive data Hines is able to understand not only the healthcare cost of the disease, but the impact on the employer through other non-healthcare benefits such as sick days.  

Affordability and Medical Debt

Award-winning journalist, Noam Levey, senior correspondent for KFF Health News, shared how affordability and medical debt has become a crisis in our country. More than 100 million people are facing healthcare debt and 1 in 5 of those do not expect to ever pay off that debt. Treatment for chronic illness creates the highest medical debt. Kentucky’s share of adults with medical bills in collections is high, as seen by this map from the Urban Institute presented by Levey.

Affordability issues aren’t totally solved by employer sponsored insurance. Levey also share a KFF Survey of Consumer Experiences with Health Insurance conducted in 2023 that posed this question: “How do Americans rate their insurance coverage?” Half of the respondents replied to the survey that their current health insurance was fair or poor based on the amount they have to pay out-of-pocket to see a doctor. Levey also shared several patient stories from people he has interviewed for his work.

National Alliance Board of Governors

The KHC is a member of the National Alliance of Healthcare Purchaser Coalitions and regularly attends their Annual Forum. The 2023 Forum marked another year of KHC engagement with the National Alliance, as remarked by Jenny Goins, President and CEO of the Kentuckiana Health Collaborative, “It is an honor as KHC’s President and CEO to serve as an officer on the National Alliance Coalition of Healthcare Purchasers Board of Governors. This year I became a member of the Board’s Finance Committee.” Immediately after the National Alliance’s Annual Forum concluded, the National Alliance outgoing and incoming CEO, board members, and other coalition leaders, visited Capitol Hill to brief legislators on healthcare topics of high interest for employers, including pharmacy and hospital costs, access to mental health care, and health plan components of ERISA (Employee Retirement Income Security Act).

National Alliance President and CEO

During the National Alliance’s Annual Forum, National Alliance staff, coalition members, and vendor partners said goodbye to Mike Thompson retiring CEO of the National Alliance. Shawn Gremminger was welcomed as the new president effective January 1, 2024. Known for his wide-ranging policy expertise, and government relations experience, Gremminger brings to the National Alliance a successful record of working with coalitions, employers and other healthcare purchasers, policy makers, and industry stakeholders toward the mission of achieving high-quality, affordable, equitable healthcare.

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