PBGH Launches Groundbreaking Health Care Data Project, Tackling Data Transparency Challenges and Strengthening Employer Fiduciary Compliance

Project will mark a significant advancement in transparency and data analytics – benchmarking commercial health care costs and quality – with strategies to inform and empower public and private purchasers to negotiate fair prices for quality services

Amid the untenable healthcare affordability crisis, Purchaser Business Group on Health (PBGH), a nonprofit coalition representing 40 private employers and public entities across the U.S., announced the launch of its commercial health care data project to equip employers with vital and unprecedented transparency on the cost and quality of commercial health care and key insights that will enable them to be effective, prudent fiduciaries.

In this first deployment, PBGH will aggregate and analyze the actual claims and demographic data from five jumbo employers and public purchasers across ten geographic markets with Hospital Price Transparency rule datasets, Transparency in Coverage (“TiC”) payer datasets and provider quality metrics to meet fiduciary requirements under the Consolidated Appropriations Act (CAA). The employers’ data will be combined with the transparency files to generate comparative commercial benchmarks correlating cost and quality and provide employer-specific use cases based on their exact data – achieving unprecedented transparency and customized analytics to inform the employers’ carrier and network strategy, direct contracting, and more.

“PBGH created this initiative because employers do not have access to the data they need to be prudent fiduciaries,” explained Won Andersen, Chief Operating Officer of PBGH. Under the project, PBGH will analyze cost variations, allowing employers to compare the best “deal” by hospital, network, and carrier based on actual prices at the service code level, rather than relying on self-reported aggregated carrier data. Additionally, it will correlate price variation data with provider quality data to provide a comprehensive understanding of value.

“We are developing a new level of transparency and analysis that does not currently exist for the commercial market,” continued Andersen. “This project represents a pivotal step toward enhancing transparency and accountability in health care spending and purchasing, ultimately benefiting employers and their employees and families.”

“The high cost of health insurance is a growing burden on employers and slows wage growth for workers,” said Caroline Pearson, executive director of the Peterson Center on Healthcare. “Yet companies that are motivated to deliver higher-value coverage for their employees still lack the data, tools, and market influence to stem the rise in health care spending. This initiative will empower employers with critical insights into the cost and quality of care to foster informed decision-making.”

The PBGH Health Care Data Project is supported by a grant from the Peterson Center on Healthcare.

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About Purchaser Business Group on Health

PBGH is a nonprofit coalition representing nearly 40 private employers and public entities across the U.S. that collectively spend $350 billion annually purchasing healthcare services for more than 21 million Americans and their families. In partnership with its members, PBGH initiatives are designed to test innovative operational programs and scale successful approaches that lower healthcare costs and increase quality across the U.S.