Pacific Business Group on Health PBGH System Transformation

Pacific Business Group on Health (PBGH) System Transformation

PBGH 501(c)(3) with societal vision: A healthcare system driven to deliver the best health outcomes, experience, and affordability for consumers and purchasers >60 private and commercial purchasers of healthcare, including… 2

3 Change Levers Care Redesign Pay for Value Influence Policy Accelerate Transparency Apply strategies in tandem (e. g. , payment to support care redesign) and across patient populations (Medicare, Medicaid, and commercial)

Example Impacts § 4, 800 CA clinicians transforming primary care for 3 million Medicare, Medicaid and commercial patients § Hospitals accounting for 39% of CA births committed to maternity best practices § 50% of unnecessary spine surgeries avoided through PBGH COEs § Adopt a single hospital payment for C-Section or vaginal birth § Influenced MACRA to reward primary care transformation § Assure availability of CMS and Health Plan data for public reporting § Release of first statewide physician-level quality measures § Consumer Reports publishes physician group Patient Satisfaction scores 4

Pulling the Levers Scaling • Payment • Transparency • Policy Scale Pilot and Sidebar Demonstrate Examples Innovate Program in one location Program Adapted for multiple locations Change the environment HNHC patients in Rural county TA for 39 organizations 1. CMS Policy 2. Payment by health plans 10

Finding Local Partners… • Network for Regional Health Improvement www. nrhi. org • SIM Grants to States https: //innovation. cms. gov/initiatives/state-innovations/