PBGH Publishes Purchaser Policy Priorities for the New Congress and Administration
January 31 2025 - 6:00PM
As the newly-elected 119th Congress readies to tackle a list of
legislative priorities, Purchaser Business Group on Health
(PBGH), a nonprofit coalition representing 40 private
employers and public entities across the U.S., shares a new Brief
detailing its health care policy priorities. PBGH members share
bi-partisan goals to reduce health care costs while improving
quality and access of health care services. PBGH members lead
innovative purchasing strategies but need policy change to enable a
functional health care market.
“We welcome the new Congress and Administration’s willingness to
disrupt an industry that has become increasingly consolidated,
unresponsive and dysfunctional,” said Elizabeth Mitchell, President
and CEO of PBGH. “The current system does not work for employers,
families or most health care providers and the industry has
demonstrated it will not reform itself to deliver high quality care
at lower costs. Legislative action is needed to curb
anticompetitive practices and enable accountability.”
To improve affordability, the Brief identifies specific policy
actions for Congress and the Administration, including:
- Lower Health Care
Costs by addressing hospital and drug pricing, limiting
consolidation, and prohibiting anti-competitive practices.
- Improve Data
Access and Transparency by enforcing hospital price
transparency and transparency in coverage regulations and enhancing
penalties for non-compliance.
- Enact Service
Provider Reforms by ensuring PBM and TPA transparency,
including reporting drug pricing data and prohibiting gag clauses,
and extending fiduciary obligations to service providers.
- Support Direct
Contracting and Joint Purchasing by clarifying antitrust
guidance allowing multiple employers to join together, and ensuring
direct contracts are covered by ERISA’s preemption law.
Many of these policy recommendations are important to enable
employers’ ability to meet their fiduciary responsibilities on
behalf of employees and families.In addition to affordability, the
Brief offers recommendations on improving access to needed
high-quality care. PBGH supports efforts to:
- Improve Maternal
and Child Health ensuring access to safe and high quality
maternal and post-partum care – especially in rural areas – through
a whole person approach and expanding access to care teams
including midwives and doulas.
- Improve Primary
Care and Mental Health by removing barriers to advanced
primary care, investing in the primary care workforce, and
integrating mental health care into primary care.
“The health care market is broken. These common-sense reforms
will go a long way toward establishing fair competition and greater
transparency will allow the marketplace to work to better control
costs and improve access to high quality care,” Mitchell said.
About Purchaser Business Group on Health
PBGH is a nonprofit coalition representing nearly 40 private
employers and public entities across the U.S. that collectively
spend $350 billion annually purchasing healthcare services for more
than 21 million Americans and their families. In partnership with
its members, PBGH initiatives are designed to test innovative
operational programs and scale successful approaches that lower
healthcare costs and increase quality across the U.S.
Janet Cabibbo
Purchaser Business Group on Health
415-615-6344
jcabibbo@pbgh.org