Purchaser Business Group on Health Receives Funding to Launch CAA Data Demonstration Project

With newly secured funding, PBGH is now able to launch its Consolidated Appropriations Act (CAA) Data Demonstration Project.

This is a first initiative of its kind, combining CAA hospital and payer datasets with provider quality metrics with specific employer demographic and claims data from five employers in 10 geographic markets.

Key reasons why employers are embarking on this initiative include: 1) informing upcoming carrier and network strategy and selection, 2) carrier performance effectiveness and accountability, 3) incorporating quality measurement into accountability, and 4) fiduciary due diligence.

With this project, PBGH will:

• Create fair-cost commercial benchmarks to help you assess whether what you are paying is fair and appropriate.
• Analyze cost variations so you can you can compare – for the first time – whether it’s the best “deal” by hospital, by network, and by carrier from “actual” price at the service code level (versus self-report aggregated carrier data).
• Correlate price variation data with provider quality data to understand value.

Participating employers will receive the analytics report with findings and recommendations, cost/price benchmarks and recommended application strategies.

The expected timeline for final deliverables is 9-12 months, with potential preliminary insights in six months.

Geographic markets include: Puget Sound, Washington; Oregon; Northern and Southern California; Phoenix, Arizona; Dallas, Texas; Denver, Colorado; Atlanta, Georgia; St. Louis, Missouri; and Northern New Jersey and New York.

All interested PBGH members can participate by contacting Won Andersen.