Health Rosetta Certification Program Guide

Introduction to the Health Rosetta

Before we get into program details, what exactly is the Health Rosetta?

The Health Rosetta is a blueprint for wisely purchasing healthcare benefits that is sourced from benefits purchasers and other experts. Think of it as an amalgamation of real life experience from benefits purchasers around the country who have successfully bucked the status quo in one way or another. Large and small. Rural and urban. Public and private. It’s an open source project that will continually evolve over time. It improves as more people contribute to its content, more organization implement its components, and more solutions emerge.

It’s a simple, bottom up way to aggregate collective expertise, insight, and experience to identify and grow adoption of high-performance benefits while combatting the complexity and opacity of the status quo. If we’re going to drive systemic change to our health care system, adopting the practical, proven solutions has to become much easier for benefits purchasers of all types.

The Health Rosetta is composed of various components that each represent a single major area of best practices and subcomponents to each component. Broadly components fall into two buckets.

These cover the processes around purchasing and administering health benefits plans, e.g., transparent advisor relationships, fiduciary duties, payment integrity, etc. They’re important because it’s hard to get to a high performance plan if the process for purchasing and administering it is as broken as it is in today’s status quo.

These cover the actual substance of what is provided through health benefits plans, e.g., primary care, major specialty areas, pharmacy, etc. They’re important because it’s difficult to sustainably reduce costs and improve quality without addressing these major areas of care and spending.

HR Components

Separate from the components themselves are Health Rosetta Strategies. These are specific strategies, solutions, tactics, and approaches that typically cross various components, e.g. data proficiency, reference-based pricing approaches, out of network claims settling, medical tourism, plan debundling, etc. They are more about how to get to the results sought by a component than a component themselves.

The lines between Health Rosetta components and strategies can get a little soft, but that’s the nature of emerging categories. The Health Rosetta component, subcomponents, strategies, and even the overall taxonomy will evolve over time.

Certification programs are built around the Health Rosetta. The Health Rosetta aggregates success stories, which the ecosystem codifies into best practices and metrics. Health Rosetta then creates certifications for people, products, services, and places that simplify adoption of Health Rosetta Components by benefits purchasers. Over time, we will certify an entire new health ecosystem of modules that can be flexibly implemented by benefits purchasers to fit their needs. It’s a very long term approach to remove the complexity of high-performance benefits and health care generally, ultimately making health care’s underperforming status quo irrelevant.