1. Accelerate the adoption of effective ACO models by health plans, providers, and purchasers. In 2016, leverage PBGH’s ACO learnings and best practices to influence national policy, and develop an ACO action plan by testing models for how PBGH can accelerate adoption of effective ACO models. Nationally disseminate the PBGH guidebook on ACO best practices and test at least three mechanisms for accelerating adoption of effective ACOs.
2. Create and spread approaches, in payment and delivery, to improve care and reduce inappropriate services for patients and issues incurring high costs for our members (e.g., maternity, medically complex).
a. Expand the Transform Maternity Care program. In 2016, secure commitments from California hospitals to participate in learning collaboratives representing 25% of births. Obtain commitments from 5 purchasers to integrate PBGH-endorsed maternity metrics into health plan contracts by 2018.
b. Expand PBGH’s high-cost care models nationally. Engage five non-California regions around high-value maternity care and obtain commitment from one regional partner outside of California to implement elements of the PBGH maternity model in 2016. Spread adoption of common care elements for high-cost patient populations.
3. Accelerate the adoption of bundled payments by health plans, providers, and purchasers in 2016. Create the foundation for broad adoption of bundled payments and gain commitment of purchasers to adopt PBGH bundled payment recommendation. Specifically, gain commitment of 15 purchasers to implement bundled payment program by 2018 that meets PBGH criteria/standards.
4. Develop and spread best practices for payment and delivery reform among purchasers nationally. In 2016, launch Purchaser Value Network. Meaningfully engage at least five regional purchaser coalitions and associations, 50 individual companies and five state purchasers.
5. Increase the number of PBGH members adopting value purchasing and APMs. Work with PBGH members to establish, monitor and achieve individual and collective targets for value purchasing and APM adoption. In 2016, produce an annual report of PBGH member organizations’ adoption of value purchasing and APMs.
Pacific Business Group on Health