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.

Contact

Won Andersen
Chief Operating Officer
wandersen@pbgh.org

Fiduciary Services

Fiduciary Governance

Enhance 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

Take 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

Ensure 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

Ensure 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)

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

Maximize available health and claims data to gain insights to ensure your vendors, providers and program effectiveness.

Data Vendor Selection and Plan Management

Get comprehensive, unconflicted assistance in the vetting and selection process of data vendors to optimize your health care spend.

Direct Contracting Services

Direct Contracting Support

Benefit 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

Ensure your vendor and service provider agreements and contracts are compliant with CAA rules and regulations.

Strategy Consulting Services

Supplier Innovation Summit

Enhance 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.

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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.

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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.

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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.

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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.

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Announcements

Purchaser Business Group on Health Announces Inaugural Care Excellence Award Recipients

The first recipients of the PBGH Care Excellence Award include: BT Health (part of Brown & Toland Physicians), (Bronze Award), Crossover Health (Bronze Award), One Medical (Bronze Award), and Vera Whole Health (an apree health brand), (Bronze Award), in recognition of their superior commitment to delivering high-quality advanced primary care, and by doing so, are helping to move the market towards greater quality, equity and affordability.

Purchaser Business Group on Health to Sunset Patient Assessment Survey Program

Without a business case for providers to measure and report patient experience, the Patient Assessment Survey (PAS) program is no longer sustainable. PBGH will sunset the program July 31, 2024. Upon conclusion of the program, PBGH will work with partners to seek new and innovative measurement methods. PBGH remains committed to enhancing health care quality and patient outcomes.

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

PBGH has launched a CAA Data Demonstration Project, which aims to complement employer claims and utilization data with pricing and quality data to provide actionable, specific insights to ensure high-value, affordable care.