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…

Accelerate Transparency Change Levers Accelerate Transparency Care Redesign Pay for Value Influence Policy Apply strategies in tandem (e.g., payment to support care redesign) and across patient populations (Medicare, Medicaid, and commercial) Multipayer Align the levers Change care from the patient We want what you want: person-centered, coordinated care, as much at home as comfortable

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

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

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