Handling patients mid-journey preauthorization

This OG of directly contracted high-value networks or Centers of Excellence networks came up, name dropped and everything in the episode with Elizabeth Mitchell from PBGH, the Purchaser Business Group on Health, from two weeks ago. That was episode 491.

So, welcome to this deep cut episode with Olivia Ross from way back, pre-pandemic times.

This episode of Relentless Health Value revisits the concept of directly contracted high value networks or Centers of Excellence (ECEN) with Olivia Ross. The discussion explores the impact and potential of the ECEN network, emphasizing the importance of quality, price transparency, and multidisciplinary approaches in healthcare.

Olivia delves into the reasons why ECEN was significant in past PBGH projects and its current relevance, despite its eventual dismantling due to corporate changes. The episode highlights the benefits for employers in creating their own high-value networks and the positive outcomes from fewer unnecessary surgeries and better quality care. Additionally, it covers the rigorous process of selecting Centers of Excellence and how continuous quality improvement efforts benefit both employers and healthcare providers.

=== LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/Take2-EP240

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07:40 Prospective bundles and the cost of care.

08:22 How the largest cost savings come from the improvements in quality.

09:51 What Olivia looks for in choosing centers of excellence.

10:36 Creating market pressure and avoiding consolidation.

11:17 Creating positive disruption in the healthcare system.

12:17 How Olivia chooses the centers and providers she works with in the Purchaser Business Group on Health.

13:12 The quality metrics Purchaser Business Group on Health looks at when assessing providers and centers.

14:04 What a team assessment is, and why it's important.

15:07 How local PCPs have to factor into this health care model.

17:57 How Purchaser Business Group on Health intervenes in the patient journey to ensure that the patient and the employer are getting the best quality care for the best price.

19:39 Olivia's suggestions on how to have an intervening conversation with a patient who has already been told he or she needs surgery.

20:18 EP468 with Matt McQuide.

20:20 EP471 with Christine Hale, MD, MBA.

20:22 EP472 with Eric Bricker, MD.

25:27 "Even at a more competitive price point, there's still an upside to them getting this new business."

25:52 How choosing specific physicians is part of the COE designation process.

27:35 How COEs and their physicians are also involved in continuous quality improvement.

30:56 Employers Centers of Excellence Network collaboration with The Leapfrog Group.

32:24 How the Employers Centers of Excellence Network program is open to any employer, no matter the size.

32:54 What it takes to join the Employers Centers of Excellence Network.