PBGH collaborates with the National Alliance of Healthcare Purchaser Coalitions on its Path Forward for Mental Health and Substance Use. Path Forward is a private sector approach to systematically and measurably improving five established best practices of mental health and substance use care.
Employers know that primary care is essential to a healthy work force and employees’ access to a high-value health care system. Studies show that robust systems of primary care can lower overall health care utilization disease and death rates and increase the use of preventive services. Strong primary care may also reduce the negative effects of income inequality and is associated with more effective and equitable health services.
Through a range of programs and initiatives, PBGH supports and advances a strong primary care system by incentivizing integrated and coordinated care that puts patients at the center.
Streamline your interactions with service providers using our contract management service. We focus on ensuring your contracts are compliant and favorable, aligning them with your key goals. Our team simplifies and manages the complex details of contract terms, ensuring you receive the best possible outcomes.
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Widespread variation in provider quality and efficiency is a major driver of health care costs. For health care purchasers who buy coverage for employees, this not only drives up health care costs but also affects employee productivity and absenteeism.
PBGH works with its members to identify the best performing, most efficient providers to control costs and to create benefit designs that encourage employees to seek high-value care. PBGH helped form one of the country’s highest-quality and most cost-effective centers-of-surgical-excellence networks.
The Practice Transformation Initiative (PTI) was a four-year initiative that engaged 4,800 clinicians statewide contracted with provider organizations to improve measures of cost, quality and patient experience. CQC is one of 41 organizations nationally included in the Centers for Medicare & Medicaid Services’ Transforming Clinical Practice Initiative, which began in 2015. CQC partnered with the Center for Care Innovations (CCI) and the Integrated Healthcare Association to execute the program.
The PTI fundamentally changed the approach to providing technical assistance and support at a broad scale in California. The project established key components that are necessary to drive change and also demonstrated that this type of work, though intensive, is more than worth the up-front investment of resources. PTI yielded a total cost savings of $186 million, equivalent to $42,000 saved per PTI enrolled clinician.
The program also yielded the following health outcomes:
CQC trained practice facilitation coaches hired by participating organizations — medical groups, independent physician associations (IPAs), community health centers and health plans — to redesign care at 2,000 clinician practices based on the 10 Building Blocks of High-Performing Primary Care. Quarterly meetings with organization leaders fostered peer-to-peer learning to accelerate progress. PTI also offered individualized coaching for each organization, virtual learning sessions, a data results portal and an online community.
Improvement was tracked at the clinician- and provider-organization levels for measures common across Value-Based Payment programs for Medicare, Commercial and Medi-Cal payers.
The CalHIVE Telehealth & Virtual Care Improvement Collaborative (2020 – 2022) provided technical assistance to clinicians to leverage telehealth for chronic disease management of patients with diabetes and asthma within the primary care setting.
Participants were seven provider organizations representing 1,300 clinicians located in eight counties throughout Southern California, the Inland Empire and the Central Valley:
The collaborative built on CQC’s, four-year Practice Transformation Initiative — which engaged over 4,500 physicians providing care for 3.1 million patients and generated $186 million in cost savings, or $10.11 for every dollar invested. The program produced dramatic reductions in emergency room utilization and hospitalizations and equally impressive gains in care quality.
Support
CalHIVE’s Telehealth & Virtual Care Improvement Collaborative was possible thanks to the generous support of CVS Health and the California Health Care Foundation.