EP491: Incumbent TPAs and Consultants Getting Called to Jumbo Employer Client HQ to Answer Awkward Questions, With Elizabeth Mitchell
Relentless Health Value
How did PBGH make the transparency data usable?
Elizabeth describes combining MRF/public files with employer claims, Milliman analysis, Imbold quality, and Leapfrog safety for reliability.
In Episode 491, Stacey Richter interviews Elizabeth Mitchell, CEO of the Purchaser's Business Group on Health (PBGH), about the PBGH Transparency Demonstration Project.
They discuss the project's aim to provide jumbo self-insured employers with transparency in healthcare costs, quality, and safety data. Collaborating with Milliman and Embold and funded by the Peterson Center on Healthcare, PBGH's project reveals no correlation between higher prices and quality in healthcare services.
The episode highlights the impacts on TPAs, consultants, and clinical organizations, and underscores the importance of employers using this new transparency data for strategic advantage and compliance with the Consolidated Appropriations Act. Richter and Mitchell delve into the broader implications for creating high-value networks and fostering market competition based on quality and affordability.
=== LINKS === đź”— Show Notes with all mentioned links: https://cc-lnk.com/EP491
✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe
đź«™ Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe
đź“ş Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue
🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1
🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b
=== CONNECT WITH THE RHV TEAM === âś LinkedIn https://www.linkedin.com/company/relentless-health-value/ âś Threads https://www.threads.net/@relentlesshealthvalue/ âś Bluesky https://bsky.app/profile/relentleshealth.bsky.social âś X https://twitter.com/relentleshealth/
06:35 How did PBGH's transparency project start?
07:35 EP428 with Julie Selesnick.
07:37 EP408 with Chris Deacon.
07:39 Why the changes to the CAA and ERISA meant heightened risk for employers and individuals within companies.
09:09 "You can't outsource the risk."
11:10 How PBGH's transparency project demonstrated some clients being noncompliant.
12:52 Why is it irresponsible not to use the data presented if you're a self-insured employer?
15:06 How did PBGH use the transparency data and apply it effectively to improve their offerings and business?
18:37 Why TPAs should not negotiate contracts.
19:17 EP485 with Cristin Dickerson, MD.
19:22 EP486 with Stan Schwartz, MD.
19:24 EP488 with Mark Cuban and Cora Opsahl.
20:58 "There is no good price for unsafe care."
21:36 How PBGH found using the transparency data to be totally feasible.
25:03 EP483 (Part 1) with Jonathan Baran.
25:32 Why the market will evolve with this data.
28:04 EP369 with Keith Hartman, RPh.
28:06 EP370 with Erik Davis and Autumn Yongchu.
28:34 What PBGH discovered about high-value centers and centers of excellence.
28:59 EP240 with Olivia Ross.
32:26 Why incentives are another challenge.
33:49 Why this is good news for unconflicted benefits consultants.
36:04 EP487 (Part 1) with Kevin Lyons.
39:48 Why transparency is going to become the new normal.
40:22 The Innovator's Dilemma by Clayton M. Christensen.
42:14 EP436 with Elizabeth Mitchell.
44:07 EP286 with John Rodis, MD, MBA.
45:22 Why there is a great incentive to be a great clinician right now.
46:18 How this information can motivate competition in the right place.
46:52 EP490 (Part 1) with Shane Cerone and Sam Flanders, MD.
The AI-powered Podcast Player
