Drug Pricing Policy
December 1st, 2020
Antitrust Advocacy
December 1st, 2020
Influence CMS Policy
December 1st, 2020
Path Forward for Mental Health and Substance Use
November 30th, 2020
PBGH collaborates with the National Alliance of Healthcare Purchaser Coalitions on its Path Forward for Mental Health and Substance Use. Path Forward is a private sector approach to systematically and measurably improving five established best practices of mental health and substance use care.
High-Value Primary Care
November 30th, 2020
Employers know that primary care is essential to a healthy work force and employees’ access to a high-value health care system. Studies show that robust systems of primary care can lower overall health care utilization disease and death rates and increase the use of preventive services. Strong primary care may also reduce the negative effects of income inequality and is associated with more effective and equitable health services.
Through a range of programs and initiatives, PBGH supports and advances a strong primary care system by incentivizing integrated and coordinated care that puts patients at the center.
Contract Review and Negotiation
November 30th, 2020
Streamline your interactions with service providers using our contract management service. We focus on ensuring your contracts are compliant and favorable, aligning them with your key goals. Our team simplifies and manages the complex details of contract terms, ensuring you receive the best possible outcomes.
Service details:
- Comprehensive Contract Review and Negotiation Support:
- Thoroughly review and redline service contracts for internal client review, along with providing strategic negotiation guidance or conducting negotiations on your behalf.
- Detailed Service Provider Assessment:
- Evaluate performance standards, including quality, access and service levels.
- Review value-based payment arrangements.
- Assess accountability standards, encompassing incentives and penalties.
- Identify and address anticipated changes that necessitate updates in contractual language.
- Analyze continuation or termination clauses of existing contract provisions.
Centers of Excellence
November 30th, 2020
Widespread variation in provider quality and efficiency is a major driver of health care costs. For health care purchasers who buy coverage for employees, this not only drives up health care costs but also affects employee productivity and absenteeism.
PBGH works with its members to identify the best performing, most efficient providers to control costs and to create benefit designs that encourage employees to seek high-value care. PBGH helped form one of the country’s highest-quality and most cost-effective centers-of-surgical-excellence networks.
Intensive Outpatient Care Program (IOCP/AICU)
November 30th, 2020
Practice Transformation Initiative (2016 – 2019)
November 30th, 2020
The Practice Transformation Initiative (PTI) was a four-year initiative that engaged 4,800 clinicians statewide contracted with provider organizations to improve measures of cost, quality and patient experience. CQC is one of 41 organizations nationally included in the Centers for Medicare & Medicaid Services’ Transforming Clinical Practice Initiative, which began in 2015. CQC partnered with the Center for Care Innovations (CCI) and the Integrated Healthcare Association (IHA) to execute the program.
The PTI fundamentally changed the approach to providing technical assistance and support at a broad scale in California. The project established key components that are necessary to drive change and also demonstrated that this type of work, though intensive, is more than worth the up-front investment of resources. PTI yielded a total cost savings of $186 million, equivalent to $42,000 saved per PTI enrolled clinician.
The program also yielded the following health outcomes:
- 40,000 patients improved HbA1c control
- 9,700 patients with diabetes improved blood pressure control
- 9,700 patients with hypertension improved blood pressure control
- Reduced unnecessary hospital use
- 47,000 avoided hospital bed days
- 17,000 avoided emergency room visits
CQC trained practice facilitation coaches hired by participating organizations — medical groups, independent physician associations (IPAs), community health centers and health plans — to redesign care at 2,000 clinician practices based on the 10 Building Blocks of High-Performing Primary Care. Quarterly meetings with organization leaders fostered peer-to-peer learning to accelerate progress. PTI also offered individualized coaching for each organization, virtual learning sessions, a data results portal and an online community.
Improvement was tracked at the clinician- and provider-organization levels for measures common across Value-Based Payment programs for Medicare, Commercial and Medi-Cal payers.
Building Capacity for Improvement
November 16th, 2020
The California Quality Collaborative (CQC) offers a variety of educational and training programs focused on building knowledge and skills in delivery system improvement. These include one-day convenings, webinars and training workshops open to both individuals and organizational teams.