Public and private employers need all the information they can get when it comes to selecting healthcare benefits for their employees. And they’ll soon get more of it, say backers of an initiative announced today by the Purchaser Business Group on Health, a group of about 40 private and public companies.
PBGH has created the Public Purchaser Advisory Committee, saying in a press release that “PBGH has long been unique among national business health coalitions in that its membership includes both private sector and public purchasers.” PPAC’s chairperson will be Don Moulds, chief health director of the California Public Employees’ Retirement System (CalPERS).
Fierce Healthcare conducted a Q&A via email about the initiative with Elizabeth Mitchell, PBGH’s president and CEO. Here's more from that conversation.
Fierce Healthcare: The press release says: “The new committee will elevate the needs of public members and help further integrate the work of public and private purchasers.” What does that mean, exactly?
Elizabeth Mitchell: PBGH is known for fostering innovative and scalable public-private partnerships. The purpose of this committee is to support public purchasers’ unique regulatory environments and their plan role, which doesn’t always include an employee-employer relationship. The collective voice of public and private purchasers will provide additional opportunity for regional and national alignment of purchaser priorities to create scalable change.
FH: Have public members felt that their needs weren’t being adequately addressed?
EM: Not at all. This committee is designed to foster additional conversations with thought leaders and to amplify the voice of the purchaser across sectors. Our new organizational goals represent the need for significant structural changes to the healthcare system and deal with population needs. Providers can’t respond and make changes when they’re asked to do different things by different payers, so alignment is needed to reduce burden and enable change.
We recently announced a pilot, as one example, in which we partnered with Covered California, CalPERS, City and County of San Francisco and eBay (the latter two joined after our release went out) who together contractually required their health plans to adopt the same quality measures to support enhanced payments for advanced primary care for the 2022 plan year.
FH: How many members will be on the committee?
EM: To start, there will be four public purchasers on the committee:
- Don Moulds, chief health director of the California Public Employees’ Retirement System (CalPERS)
- Abbie Yant, executive director of the San Francisco Health Service System
- Sue Birch, RN, director of Washington State Health Care Authority
- Alice Chen, M.D., Covered California’s chief medical officer
We expect more PBGH public purchasers will join.
FH: In a broad sense, how do the needs of public members differ from the needs of private members?
EM: As mentioned above, our public members, such as Covered California, don’t always have an employee-employer relationship. They also tend to be regionally focused as opposed to national and deal with Medicaid, which is different than our large private employer members. And of course, depending on the entity, they have a different relationship with their state legislators.
Still, state purchasers face similar pressures to private employers and to the extent that the commercial market aligns with the public sector on similar goals we have a better chance of making changes for a broader population. Mental health, for example, is a top priority for public and private purchasers alike and it will take everyone working together to solve systemic failures.
FH: Has this been something that you’ve been pushing for some time with the PBGH?
Mitchell: No. PBGH is unique among other coalitions in that it’s always had public and private purchasers in its membership. But the new goals we’re setting are ambitious and so we want to ensure that the public-private integration is elevated even further. It’s difficult to achieve the kind of changes we’re after if those making the effort cover just 20% of an overall population. Public-private collaboration is essential to scaling innovations.
FH: Did COVID-19 underscore the need for such a committee?
Mitchell: COVID exposed the preexisting conditions of the health care system and highlighted significant failings in terms of equity, how fee-for-service seriously threatened primary care, among other issues. We had hoped in the face of such failings the system might reinvent itself but instead it doubled down on the status quo.