Take Two: EP240: A Direct Contracted and Actually High-Value Network That Elizabeth Mitchell From PBGH Talked About, With Olivia Ross

Nov 20, 2025

Olivia Ross, an experienced leader in employer-centered healthcare programs, dives into the world of high-value networks and Centers of Excellence. She explains how these networks allow self-insured employers to deliver predictable pricing while improving care quality. Olivia highlights the benefits of coordinated care with local providers and the importance of rigorous quality metrics when selecting surgeons. With innovative strategies for engaging patients, she demonstrates how employers can leverage their buying power to drive competition and enhance healthcare outcomes.

Ask episode

AI Snips

Chapters

Transcript

Episode notes

INSIGHT

Employers Can Build Their Own High-Value Networks

PBGH's data demonstration lets plan sponsors compare price, quality, and safety to build their own high-value networks.
Self-insured employers can now create Centers of Excellence without intermediaries using available transparency and claims data.

INSIGHT

Direct Contracts Outperform Generic Networks

Direct contracts between employers and clinical organizations outperform most third-party negotiated deals.
They align specific services to specific populations and avoid undisclosed middleman arbitrage.

INSIGHT

Opaque Middlemen Inflate Employer Costs

Self-insured employers often pay roughly 30% more on claims than clinicians receive due to opaque middlemen payments.
Lack of disclosure about that added cost is the core problem, not administrator compensation per se.

Get the Snipd Podcast app to discover more snips from this episode

Get the app

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

✉️ Enjoy this podcast? Subscribe to the free weekly newsletter: https://relentlesshealthvalue.com/join-the-relentless-tribe

🫙 Support the podcast with a small donation to the Tip Jar: https://relentlesshealthvalue.com/join-the-relentless-tribe

🎤 Listen on Apple Podcasts https://podcasts.apple.com/us/podcast/feed/id892082003?ls=1

🎤 Listen on Spotify https://open.spotify.com/show/6UjgzI7bScDrWvZEk2f46b

📺 Subscribe to our YouTube channel https://www.youtube.com/@RelentlessHealthValue

=== CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitter.com/relentleshealth/

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.