PBGH Advisory Services
As the market dynamics shift and new regulations emerge, PBGH ensures your organization is poised to navigate the complexities of the Consolidated Appropriations Act (CAA). With ERISA’s “prudent expert” standard now applied to health plan fiduciaries, our suite of services is tailored to ensure your organization remains compliant. We help you leverage innovative cost-saving strategies and proactively monitor your programs for optimal performance.
4 Reasons Why PBGH is Your Trusted Partner for Achieving Fiduciary Success and CAA Innovation and Compliance:
- Unconflicted Advisor: PBGH is a mission-based organization working solely in the interest of employers and purchasers. We are an unconflicted partner dedicated to your success. We do not accept industry commissions.
- Unparalleled Expertise: Our team, renowned for bringing health care innovations like Employer Center of Excellence Network (ECEN) and advanced primary care (APC) to market, demonstrates a proven track record in the industry. PBGH excels in bringing together public and private sectors for collective impact, fostering collaborative solutions. Our engagement in shaping health policy sets us apart, as we leverage our expertise for broader systemic change.
- Tailored Solution: Each project is carefully customized to meet your unique requirements and objectives.
- Clear and Fair Pricing: Our pricing is transparent and based on the scope of your project. We bill strictly time and materials, guaranteeing that you receive true value for your investment. Due to our cost structure and mission orientation, our rates are lower than typical for-profit consultants.
Fiduciary Services
Fiduciary Governance
Read More about Fiduciary GovernanceEnhance your organizational governance with tailored structures, processes and oversight strategies designed to meet your specific needs, ensuring that you are operating with the highest level of fiduciary responsibility and efficiency.
Fiduciary Training and Learning
Read More about Fiduciary Training and LearningTake advantage of customized training curriculum to align your benefits, compliance, finance and leadership teams on the complexities of CAA compliance, including gag clauses, governance oversight requirements, transparency requirements and more.
Supplier Accountability
Read More about Supplier AccountabilityEnsure your TPAs, carriers, point solutions, and benefit consultants/brokers, are acting in your best interest and are providing you with valuable service at reasonable cost.
Contract Review and Negotiation
Read More about Contract Review and NegotiationEnsure your vendor and service provider agreements and contracts are compliant with CAA rules and regulations.
Data Analytics Services
Network Optimization with Hospital and TiC Data (CAA Data)
Read More about Network Optimization with Hospital and TiC Data (CAA Data)Using a unique combination of in-depth measurement and technical expertise in conjunction with newly available CAA data, gain the insights you need to make effective and efficient decisions on how to optimize your network in a specific geography and meet your fiduciary obligations.
Data Analyst Services
Read More about Data Analyst ServicesMaximize available health and claims data to gain insights to ensure your vendors, providers and program effectiveness.
Data Vendor Selection and Plan Management
Read More about Data Vendor Selection and Plan ManagementGet comprehensive, unconflicted assistance in the vetting and selection process of data vendors to optimize your health care spend.
Direct Contracting Services
Direct Contracting Support
Read More about Direct Contracting SupportBenefit from specialized expertise to develop and implement direct contracting strategies for better outcomes and lower total costs. Our comprehensive approach addresses all aspects of direct contracting, from assessing your unique needs to selecting partners and negotiating terms.
Contract Review and Negotiation
Read More about Contract Review and NegotiationEnsure your vendor and service provider agreements and contracts are compliant with CAA rules and regulations.
Strategy Consulting Services
Supplier Innovation Summit
Read More about Supplier Innovation SummitEnhance your program by partnering with top-tier suppliers who offer innovative solutions tailored to the evolving needs of your workforce.
Resources
What Employers Need to Know About Removing Gag Clauses from Health Care Contracts
Before the clock strikes midnight on December 31, 2023, private employers and other public health care purchasers will have been required to attest to their benefit plan contracts being free of gag clauses.
4 Steps for Large Employers to Meet Fiduciary Duties and Mitigate Legal Risk
The Consolidated Appropriations Act (CAA) has created both opportunities and risks for employers when it comes to overseeing employee health benefits.
A CFO’s Guide to Health Plan Fiduciary Leadership
The Consolidated Appropriations Act (CAA) of 2021 mandates employer access to new and critically important insights into the prices they’re paying for employee health care services.
4 Key Employer Health Trends for 2023
With the pandemic’s grip finally easing, employers are shifting their focus toward key objectives that can support sustained improvements in health care quality and meaningful reductions in cost.
Advice from a Purchaser Who Took on Health Care’s Status Quo and Won
Dig into the data. Read the fine print. Follow the money. That’s Marilyn Bartlett’s advice to employers and purchasers struggling to contain soaring health care costs and looking to gain greater transparency.