More Than 30 Years of Meeting Our Mission

PBGH is a change agent creating increased value in the health care system through purchaser collaboration, innovation and action and through the spread of best practices.

2019 | Practice Transformation Initiative

Created $186 million in health care cost savings among 13 provider organizations representing 4,800 physicians through a $18.4 million CMS grant.

Improved outcomes for 40,000 diabetic patients, with patients avoiding 47,000 hospital days and 17,000 avoided Emergency Department visits.

2015 | CMS Innovation Grant: Intensive Outpatient Care Program (IOCP)

PBGH along with its members piloted one of the first outpatient programs to care for medically complex patients under a $19.2 million CMS grant.

Of patients in PBGH’s IOCP, 33%
experienced a reduction in depression symptoms.

Emergency Department and inpatient admissions use fell, resulting in cost savings of 21%.

2013 | Employers Center of Excellence

PBGH’s Centers of Excellence program has served more than 6,000 patients for joint, spine, bariatric and cancer care.

Of the patients in the Employers Centers for Excellence Network (ECEN), 50% avoided unnecessary spine surgery.

PBGH’s Centers of Excellence program has reduced total health care costs by $115 million through bundled payment design and has avoided complications.

2011 | Patient-reported Outcomes Measurement

PBGH launched and reported to the California Joint Replacement Registry and publicly reports patient-reported outcomes for hip and knee surgeries.

National Patient-Reported Outcome Measures (PROMs) strategy introduced in oncology care and depression management.

2010 | National Health Policy and Affordable Care Act (ACA) Impact

PBGH congressional testimony, know-how and lessons learned influenced the content of the ACA, including the Quality Reporting System for the Exchange plans.

PBGH helped incorporate elements that mattered to employers and consumers into the ACA.

2006 | Better Quality Information

PBGH was selected as one of six national pilots to receive Medicare Fee-for-Service claims data for physician-level quality performance measurement.

Results used to designate “Blue Ribbon” primary care physicians in health plan provider directory.

2003 | California Quality Collaborative (CQC) Formed

Following the successful Diabetes Quality Initiative, CQC expanded the Breakthroughs in Chronic Care Program to help provider organizations excel in clinical quality.

2002 | Consumer Purchaser Alliance

PBGH launched a new era of provider rating transparency through the Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs.

PBGH and its members catalyzed Medicare’s first-ever financial penalties for hospitals with high “never events.”

2002 | Breakthrough Plan: Consumer-Directed Health Care

PBGH members were early adopters of consumer-directed health plans and ushered in a new generation of price transparency and consumer decision-support tools.

2001 | Standardized Public Reporting

PBGH led the U.S.’s first statewide collaboration of HMOs to standardize pay-for-performance measures.

2000 | Leapfrog Group

PBGH cofounded the Leapfrog Group, which set hospital patient safety standards and led to better patient outcomes.

1999 | PacAdvantage: Forerunner of the Affordable Care Act (ACA) Exchanges

Helped 8,000 small businesses access affordable health insurance with standardized benefits, multiple plan choices and enhanced decision support through an online Plan Chooser.

1998 | CALINX

Harmonized early standards for electronic health care data exchange for enrollment, pharmacy, medical claims and clinical laboratory data.

1995 | Physician Value Check

Developed Physician Value Check, which became the basis for CG-CAHPS, the gold standard for measuring patient experience with provider groups in the U.S.

1994 | Clinical Outcome Accountability

PBGH was the nation’s first employer coalition to hold hospitals accountable for clinical outcomes, working with California state agency to report cardiac bypass surgery outcomes and C-section rates.

1993 | Negotiating Alliance

Joint purchasing using standardized HMO benefit designs resulted in a 9.5% reduction in premiums.

Of premiums, 2% are at risk for performance guarantees. Penalties seed annual $1 million Quality Improvement Fund.

1992 | First Public Quality Measures

PBGH was first to publish health plan satisfaction survey results and formed the California Cooperative Healthcare Reporting Initiative (CCHRI) to govern statewide plan and medical group patient experience and clinical quality measurement.