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Cost & Delivery Institute
Mission & Objectives
The Cost & Delivery Institute is a select group of Business Group members who convene for insightful and productive dialogue on strategic topics related to health care cost trends and delivery system transformation. The Institute focuses on finding effective solutions to the health care benefits challenges that large employers grapple with. Meetings create a forum to benchmark, address specific issues that are important to controlling health benefits costs, improving care quality and safety and engaging employees. Institute members learn from one another, share actionable insights and hear from experts and partners about emerging trends and proven solutions.
Participation in the Institute informs self-insured employers’ decision-making, offers information necessary to establish themselves as leaders in health care benefits and provides a platform for sharing success stories in pursuit of transformation and improvement in health care.
Institute Objectives:
  • Provide a forum for innovative benefit leaders, health plans and select industry partners for health care cost and delivery-focused discussions and to inform their decision-making process;
  • Evaluate specific issues that are important for controlling costs, improving quality and access and adopting value-based care and payment models;
  • Identify, analyze and evaluate the most promising practical solutions to the health care cost crisis relevant to self-insured employers;
  • Inform development of alternative approaches and the business case for these alternatives, along with analysis of solutions, including how to pay for the explosion of new technologies;
  • Keep members on the leading edge of innovation and health care transformation;
  • Identify emerging strategic and structural changes in the health care delivery system that potentially will change the health care cost/value equation in the long term and how these changes may re-define the role of employers;
  • Influence the agenda of Business Group conferences and publication topics to showcase emerging trends and generate actionable insights for members; and
  • Monitor developments in health care policy, share timely insights and identify the potential impact of changes on employers.

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Leadership Committees
Two leadership committees are housed under the Institute, which focus on specific tactics for controlling costs and improving the quality and safety of health care.
Evidence-based Benefit Design Committee
Pharmacy Benefit Committee
Evidence-based Benefit Design Committee
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Mission & Objectives
The Evidence-based Benefit Design Committee seeks to promote value in health benefit plan design by identifying opportunities to incorporate evidence-based guidelines into coverage and programmatic decisions. The Committee provides much needed guidance for self-insured employers in the era of rapid clinical innovation and progress, helping them allocate the resources in accordance with latest evidence and best practices. Identifying gaps between plan coverage and medical evidence enables the Committee to provide recommendations for plan design, network configuration, provider and program selection and helps employers anticipate upcoming cost pressures and meet the needs of their employees. Committee members include employer leaders in health care benefits and employee experience, thought-leading partners representing research, accreditation, physicians, health plans and consumers.
The Evidence-based Benefit Design Committee seeks to promote value in health benefits plan design by:
  • Creating a forum for employers, physicians, health plans, consumers and research and policy experts to advance a new framework for health care based on medical evidence;
  • Identifying gaps between the care that the best medical evidence suggests patients should receive and what employers are incentivizing, covering, and communicating to employees in practice;
  • Translating evidence assessments into recommendations for plan design elements and employee supports to reduce misuse and overuse of health care and direct spending to high-value services;
  • Developing employee communications that encourage sound decision-making;
  • Promoting primary care and health information exchange (HIE) reforms;
  • Enabling employers to promote shared decision-making, thereby empowering their members to become active and informed participants in their health journey;
  • Identifying quality and meaningful measures of physician performance;
  • Evaluating emerging payment models and plan design innovations aimed at improving care quality and efficiency; and
  • Reducing misuse and overuse of health care and re-directing spending toward high-value services.

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Pharmacy Benefit Committee
evidence-based-benefit
Mission & Objectives
The goal of the Pharmacy Benefit Committee (PBC) is to support the sustainability of employer-sponsored prescription drug benefits.
At a time when unprecedented price tags and foreboding pharmaceutical cost trends threaten employers’ ability to continue to provide coverage, our committee objective has become more critical than ever before. Business Group data continue to highlight high-cost therapies as the top concern for employers when it comes to managing their pharmacy benefits. This growing pain point has led to increased activity on both the medical and pharmacy side, with employers rolling out various initiatives to help curb costs and maintain the integrity of plan design.
By joining PBC, employers have an opportunity to hear from industry experts and peer innovators on cutting edge pharmacy tools and solutions and to benchmark best practices for managing pharmacy costs and ensuring patient access to high-quality pharmaceutical care.
  • Create a community of like-minded peers to learn from and support on trending pharmaceutical issues and everyday challenges;
  • Explore and harness a diversity of perspectives represented by colleagues across many aspects of the pharmaceutical supply chain (e.g., pharmacy benefit managers, health plans, pharmaceutical manufacturers, genetic testing companies);
  • Leverage best practices for optimizing value in pharmaceutical benefits and zeroing in on total cost of care with access to thought leadership from industry and policy experts;
  • Remain on the leading edge of industry innovation, closely following the specialty pipeline and groundbreaking advancements in precision medicine;
  • Explore and support the linkages between drug adherence, health and productivity;
  • Build an agenda for discussion topics, committee resources and products based on timely and relevant member priorities; and
  • Provide a channel for confidential sharing of ideas and experiences among PBC members.

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Scope Of Work
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