The Purchaser Business Group on Health (PBGH) is expanding its advisory services to all large employers to help them meet their fiduciary responsibilities, the organization announced(Opens in a new window) last week.
PBGH(Opens in a new window) is a nonprofit representing 40 private employers and public entities in the U.S. These advisory services were previously only available to PBGH’s members. However, the organization felt it was important to expand to any self-funded employer given the challenges they’re facing with rising healthcare costs and a lack of transparency from the healthcare industry.
“We want to have the broadest impact and share our knowledge and learning,” said Won Andersen, PBGH chief operating officer and leader of PBGH Advisory Services, in an interview. “So we really decided that it was time to open up our services to any purchaser.”
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Self-insured employers have a fiduciary responsibility to make sure they’re offering employees the best medical benefits for the best price. To help employers fulfill this responsibility, PBGH’s advisory services fall under four main buckets, according to Andersen.
The first is around helping employers develop a governance structure and providing fiduciary training. The second bucket is focused on helping employers select employee benefits consultants, pharmacy benefit consultants, third party administrators and carriers that will align with their fiduciary responsibilities. Sometimes consultants have a conflict of interest as some PBMs and TPAs will give them financial incentives to direct employers to their companies.
The third category is supporting employers with their data to help them benchmark healthcare costs and understand the quality of their healthcare benefits. Lastly, PBGH helps employers with the strategy and design of their health benefits, including finding opportunities for direct contracting with providers.
These services are available to employers at an hourly rate, depending on the scope of the project, Andersen said.
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This kind of support is needed given the pressure that self-funded employers are under right now. Many are struggling to access their data from TPAs and PBMs, making it challenging to understand if they’re fulfilling fiduciary responsibilities.
Employees are also starting to sue employers for not meeting their fiduciary duties. This was seen in a recent class action lawsuit(Opens in a new window), in which employees alleged that JPMorgan Chase mismanaged its employee health and prescription benefits program, leading to employees overpaying for premiums and out-of-pocket costs.
By opening up these advisory services to more employers, PBGH aims to “amplify that there are new ways to think about purchasing and new best practices that [employers] could be working towards,” Andersen stated.
“We want to certainly have a next-generation procurement and fiduciary platform that really helps employers understand how to vet providers, carriers [and] doctors they’re contracting with … and aligning that with purchaser goals, whether it is more affordability [or] high-quality care,” she said.
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