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Do You Know Your Hospital's Safety Grade?

Do You Know Your Hospital's Safety Grade? 

Unfortunately, In the spring 2022 round of The Hospital Safety Grade, metro-Memphis hospitals fell behind the national averages for hospitals with an “A” (30%) compared the national average (33%), and the percentage of Memphis hospitals with an "A" and "B" (40%) compared to the national average (57%).

In the greater Memphis area, 10 hospitals were graded, and three earned an “A,”  one earned a “B,”  five earned a “C” and one (1) earned a “D”. No Memphis hospitals earned an “F.”

Methodist Le Bonheur Germantown, Methodist South, and Methodist Olive Branch received an “A”. Methodist North received a “B”. Note: specialty hospitals, including pediatric and women’s hospitals, are not graded by The Leapfrog Group and in this round, Methodist University Hospital was not graded.

Five measures of patient experience that have a direct tie to patient safety are Included in the over 30 measures of patient safety used to calculate the Hospital Safety Grade. In the greater-Memphis area nine out of the ten hospitals received "below average" ratings on all of these patient experience measuresindicating they were among the worst performing nationally. Only Methodist Olive Branch received any above average (2 measures) and average (1 measure) ratings out of the five patient experience measures.

Leapfrog's report on  Patient Experience During the Pandemic: Adult Inpatient Care provides insight into  how patient experience has declined between the pre-pandemic and mid-pandemic timeframe.

Recent studies have shown that the pandemic has reversed years of progress on patient safety efforts. The updated data included in the Safety Grade, some of which reflects a pandemic-era timeframe, heighten these findings and demonstrate how patient care worsened due to strains on the health care system and workforce.

For detailed results on all Memphis hospitals click here.

Click here to access safety grades for nearly 3,000 hospitals nationwide.

Posted by Cristie Travis at Wednesday, May 25, 2022

Register Now for MBGH's 2022 Wellness & Health Benefit Conference

The Great Resignation: Role of Health Benefits in Recruitment & Retention 

REGISTER HERE for our August 16, 2022 Annual Wellness & Health Benefits Conference. We are excited to be back in-person and look forward to being with everyone. 

An estimated 48 million employees quit their jobs in 2021 and there is no end in sight! In January 2022 the quit rate was only slightly below the all-time high experienced in November 2021. And, even more disturbing, it is estimated that 66% of employees are still considering leaving. They are leaving for better pay; better work/life balance; and better benefits.

Attractive health benefits are critical to employers successfully recruiting new workers and retaining critical talent. Employees are looking for:

Affordable benefits; 
Personalized benefits; and 
New, innovative benefits.

Attend our conference and learn from experts how to position your health benefits to be attractive in each of these three critical areas. 


First registration gets a door prize! You must be present to win!

Posted by Cristie Travis at Wednesday, May 25, 2022

What's the CAA? (and why should I care?)

In December 2020, the U.S. Congress passed the Consolidated Appropriations Act (CAA) which builds on prior hospital and health plan transparency legislation and regulation by adding requirements that improve purchaser decision-making, network design, and anti-competitive contracting. 

Self-funded employer sponsored health plans are subject to the provisions of the CAA which include such items including member decision making, such as price comparison tools, advanced EOBs, accurate provider directories, and new plan ID cards. The provisions also include new purchaser decision making support, such as eliminating gag clauses; health plan price transparency; prescription drug transparency; broker/consultant financial disclosures. In addition, the CAA advances the mental health and substance abuse parity requirements.

Here are some resources you can use to better understand your fiduciary responsibilities under the CAA, as well as understand the compliance process and early results from employers that have already been audited. Please note that mental health parity has been the law since 2008 and federal regulators believe that employers should be much further along in compliance with these requirements than newer provisions.

Note: these resources were current as of the date they were posted and more current information may now be avaialble, so please use this information as background and see current information for any final decisions.

National Academy for State Health Policy: Transparency Regulations and the CAA: A Checklist for SEHPs. Although specifically addressing state employee health plans, this website provides a good overview of the requirement and steps employers can take. Note that all of the cited provisions apply to non-state employee health plans as well.

DOL, HHS, and Treasury: Report to Congress "Realizing Parity, Reducing Stigma, and Raising Awareness: Increasing Access to Mental Health and Substance Use Disorder Coverage" This report highlights the increased emphasis on enforcement and provides results of the early comparative analysis submitted by employers re: mental health parity.

Employee Benefits Security Administration: Compliance Assistance Guide: Appendix A-Self-Compliance Tools (mental health parity) Please note the disclaimer on this site:  "the 2020 MHPAEA Self-Compliance Tool was last updated before the enactment of the Consolidated Appropriations Act, 2021 (CAA), and while it suggests using the tool as a best practice, it does not reflect that plans and issuers subject to MHPAEA are now required to perform and document their NQTL comparative analyses under the CAA. Plans and issuers that have carefully applied the guidance in the Self-Compliance Tool should be in a strong position to comply with the CAA’s requirement to perform and document a comparative analysis with respect to the design and application of NQTLs.

The Leapfrog Group, National Alliance, ERIC, and Health Transformation Alliance: CAA Compliance Center Resources, upcoming webinars, and recordings of previous webinars on CAA compliance.

MBGH members are invited to participate in HealthCare 21 Business Coalition's upcoming webinars in March and April on CAA fiduciary requirements. Check out the MBGH Calendar for these and other CAA webinars.

Posted by Cristie Travis at Tuesday, March 22, 2022

Decide & Act: Strategies to Prevent Obesity & Diabetes

According to the CDC, 70% of adult Tennesseans are overweight or obese. Workers that are overweight or have obesity have increased risks of serious diseases, including diabetes. Three times the number of people diagnosed with diabetes have pre-diabetes. Without lifestyle changes, most people with pre-diabetes will develop type 2 diabetes in 5-6 years.  Therefore, it is essential that employers deploy programs that have a proven track-record of preventing or delaying conversion to type 2 diabetes such as The Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program (National DPP).

What is the National DPP?

  • Can prevent or delay type 2 diabetes by 58%.
  • Offers a full year of support to achieve and maintain lifestyle changes.
  • Is built on a CDC- required curriculum grounded in proven lifestyle change approaches.
  • Requires recognized providers to adhere to CDC’s scientific standards and outcomes monitoring.
  • Can be offered through different modalities (e.g., in-person, online, etc.)
  • Produces a three-year ROI of approximately $8,000 compared to a program cost of approximately $500.

Decide and Act!

Take the following four steps to determine if the National DPP is right for you and to implement the program. Details for each step are available here . Tools, templates, resources are available here.

Assess Readiness: Take the readiness assessments, Part 1 and Part 2; use the Employer ROI Calculator; estimate your budget using the template.

Prepare Case for Coverage: Use the Case for Coverage templates and resources to create a compelling case; determine internal decision makers.

Plan the Benefit: Engage internal team to plan, design, and implement program ; set program goals, including key metrics to evaluate success.

Assess Success/Scalability: Create a balanced scorecard using metrics from Stage 4 in the Case for Coverage; if conducting a pilot, evaluate scalability.

Learn from Employers Who Have Had Successful Implementations

Memphis Business Group on Health and HealthCare 21 Business Coalition recently convened a panel of Tennessee employers who have successfully implemented the National DPP. See the panel discussion at Key themes include:

  • To better ensure participation, offer the program at no cost to the employee.
  • Employers are utilizing TPA partner vendors (such as Omada, Livongo) for the program instead of directly contracting with National DPP vendor.
  • Virtual program delivery is the mode of choice with positive results, and you can consider supplementing virtual with in-person for employees that prefer that mode.
  • Programs offer outcomes-based pricing models.
  • Employers drive engagement by offering multiple enrollment campaigns throughout the year.
  • Employee testimonials create increased program engagement.

See best practice tips from the CDC and National Association of Chronic Disease Directors for securing meaningful employee engagement at . Key themes include:

  • Tailor program design to meet employee preferences and needs.
  • Identify the right employees to participate.
  • Work closely with vendors to execute and monitor engagement.
  • Cultivate champions (leadership and participants).
  • Plan for and deliver regular diabetes prevention messaging.
  • Consider incentives similar to other wellness offerings.

Check out the entire Feb. 9 employer webinar at

Click here for webinar slides

Memphis and west Tennessee employers interested in learning more about the National DPP and opportunities to participate in this special project, please contact [email protected]

Middle and east Tennessee employers interested in learning more contact [email protected]

Funding for this article was made possible, in part, by the Centers for Disease Control and Prevention. The views expressed in written meeting materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

Posted by Cristie Travis at Monday, February 21, 2022

Happy New Year! 2022 Priorities

We had hoped that 2020 was an unusual year, but as 2021 showed us, COVID-19 is still very much with us and we are still navigating toward our new normal. MBGH will continue to provide opportunities for you to learn how other employers are adapting; engage with national and regional experts on implementation of key strategies essential to achieving business goals; and access to thought leadership on preparing for the future. 

COVID-19 continues to exacerbate and make more visible and urgent health benefit issues MBGH will prioritize in 2022. 

  • Increased mental health and substance use needs due to isolation, stress, uncertainty and more.
  • Recognition that employee health resiliency is essential to withstand the physical and emotional strains from the pandemic and remain productive at work. This is especially true for weight management as obesity is, perhaps, the most important underlying condition leading to severe COVID disease and death.
  • Realization that health and healthcare are unevenly experienced even when health benefits are the same.
  • The business imperative to attract and retain worker with health benefits they value.

And, of course, we will continue our work with members on their COVID-19 strategiesour bi-monthly Health Benefits and Health & Well-Being Peer Roundtables; timely webinars and action briefs; our annual conference and complimentary/discounted access to other conferences; and more!

We look forward to working with you this year to advance our mission to bring employers together to share solutions and to provide tools and resources to manage the cost and quality of health benefits in ever changing times. I think we can all agree, these are, indeed, ever changing times.

Posted by Cristie Travis at Tuesday, January 11, 2022

Two Memphis-area Centers Named Top Ambulatory Surgery Centers

Two (2) Memphis-area ambulatory surgery centers are among the 13 Top ASCs nationally named by The Leapfrog Group in the inaugural year of the Top ASC awards – Wolf River Surgery Center in Germantown and Le Bonheur East Surgery Center in Memphis, both affiliated with the Methodist Le Bonheur Healthcare system

The competitive, national award, honors the top performing ASCs as identified through the annual Leapfrog ASC Survey. Selection was based on mastery of quality standards across several areas of ASC performance including staffing, patient experience, hand hygiene, surgical checklist protocols, and error prevention.

“Since over 60% of all surgeries in the U.S. take place in an ASC or Hospital Outpatient Surgery Department, the quality and safety of these providers is increasingly important to patients and their employers, who can use the data for decision-making and contracting, “ said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health (MBGH).  “We are excited to have two of the 13 Top ASCs right here in the Memphis-area. Their top performance reflects a commitment to quality and safety not only in hospitals but across the system.”

Click here to see a list of all Top ASCs.

Click here to see performance from all reporting Memphis-area hospitals and ambulatory surgery centers. To compare Hospital Outpatient Surgery Department performance to ASC performance, select the “elective outpatient surgery” categories for each hospital.

Posted by Cristie Travis at Wednesday, December 1, 2021

Memphis-area Hospitals Continue to Out-perform Others on National Hospital Safety Grades!

In the fall 2021 round of The Hospital Safety Grade, once again the percentage of Memphis hospitals with an “A” (55%) surpassed the national average (32%)! And, the percentage of Memphis hospitals with an "A" and "B" (64%) also surpassed the national average (58%).  Four  years ago, only 10% of Memphis area hospitals received an "A" and only 20% received an "A" and "B". 

"We are pleased to see this significant momentum continue in the improvement of Memphis area hospitals' Hospital Safety Grades, especially given the stresses on the healthcare systems due to the COVID-19 pandemic. This type of increase in performance is only possible with a relentless commitment to patient care, quality, and safety every day with every patient. Sustained improvement over time results in fewer preventable medical mistakes, less patient and family suffering, and even lower costs." said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health (MBGH). MBGH is the Leapfrog Regional Leader for eastern Arkansas, west Tennessee, and north Mississippi.

For the second time this year, all Methodist Le Bonheur Healthcare hospitals earned an “A”. “As on a school report card, these grades exemplify our eagerness to learn and improve while collectively working together to pursue the highest level of excellence in patient care,” said Michael Ugwueke, Methodist Le Bonheur Healthcare President and CEO.  “Our steadfast focus and attention to detail directly correlate to better health outcomes for our patients.”

In the greater Memphis area, 11 hospitals were graded, and six (6) earned an “A,” one (1) earned a “B,” three (3) earned a “C” and one (1) earned a “D”. No Memphis hospitals earned an “F.” Methodist Le Bonheur Germantown, Methodist North, Methodist Olive Branch, Methodist University, Methodist South, and Saint Francis Hospital – Bartlett received an “A”. Saint Francis Hospital- Memphis received a “B”. Note: specialty hospitals, including pediatric and women’s hospitals, are not graded by The Leapfrog Group.

For detailed results on all Memphis hospitals click here.

Click here to access safety grades for 2,901 hospitals nationwide.

Here is a tool kit for employers to use as you evaluate the impact of hospital safety on your health benefit plans and your employees and their families. This toolkit also includes communication material you can share with your employees so they can get the safest care possible.

Posted by Cristie Travis at Wednesday, December 1, 2021

A Proven Solution to Prevent/Delay Diabetes

The Problem

Tennessee employers face an increasingly unhealthy labor pool! 

  • According to the CDC, 70% of adult Tennesseans are overweight or obese. 
  • Overweight or obese workers have increased risks of serious diseases, including diabetes.
  • The cost of care for people with diabetes is 2.3 times more than for people  without diabetes.
  • 3 times the number of people diagnosed with diabetes have pre-diabetes

The Answer

To effectively manage your employee health benefits, addressing obesity, as an underlying cause of diabetes and other chronic conditions, is an essential strategy. Memphis Business Group on Health (MBGH) and HealthCare 21 Business Coalition (HC21) recommend a comprehensive, evidence-based benefit design to reach as many of your employees as possible with approaches that will be successful for them.

A Proven, Lifestyle Management Solution: The National Diabetes Prevention Program

Without lifestyle changes, most people with pre-diabetes will develop type 2 diabetes in 5-6 years.  Therefore, it is essential that employers deploy programs that have a proven track-record of preventing or delaying conversion to type 2 diabetes such as The Centers for Disease Control and Prevention’s (CDC) National Diabetes Prevention Program (National DPP).

The NDPP: 

  • Can prevent or delay type 2 diabetes by 58%.
  • Offers a full year of support to achieve and maintain lifestyle changes.
  • Is built on a CDC- required curriculum grounded  in proven lifestyle change approaches.
  • Requires recognized providers to adhere to CDC’s scientific standards and outcomes monitoring.
  • Can be offered through different modalities (e.g., in-person, online, etc.) 
  • Has a three year ROI of approximately $8,000  compared to a program cost of approximately $500.

How to Participate

Over the next eight months, MBGH and HC21 are working in partnership with the Tennessee Department of Health, the National Association of Chronic Disease Directors, and the CDC to increase adoption of the National DPP in Tennessee. We will also work with Tennessee employers that already offer the program to improve program effectiveness and employee participation.

Employers can participate now by:

  • Attending a second webinar in February 2022 on evaluating the National DPP for your employees and best practices in program implementation
  • Completing an Employer Market Assessment survey in January to identify employers interested in one-on-one technical assistance for program evaluation and implementation.
  • Reaching out if you would like to be considered for employer interviews on issues and barriers.
  • Joining the Employer Network national collaborative at to improve program effectiveness or to learn more as you consider implementing National DPP.

Later in 2022, employers will be invited to roundtable discussions to learn from each other and share best practices. In addition, a limited number of employers will be eligible for one-on-one technical assistance. Throughout the project, employers will receive tools and resources to assist with evaluation and implementation.

For more information on the National DPP and for background and sources for this article,

  • Click here to view the November 18th National DPP webinar
  • Click here to get the slide deck from the November 18th webinar

Memphis and west Tennessee employers interested in learning more about the National DPP please contact [email protected]

Middle and east Tennessee employers interested in learning more contact [email protected]


Funding for this article was made possible, in part, by the Centers for Disease Control and Prevention. The views expressed in written meeting materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

Posted by Cristie Travis at Monday, November 29, 2021

Get Resources from "Redesigning for Results" Sessions!

Our second virtual conference (and I hope our last) was a success! Continue your learning and strategic thinking about our topics by using these resources: 

Click here for the presentations

Click here for the conference material

1.  Redesigning Through an Equity Lens: To Realize Workforce Potential: Andrea Willis, MD (bottom center) of BCBS of Tennessee and Tsveta Polhemus (top left), of NCQA made the case that you need to understand and address the needs of subpopulations in your workforce that carry a disproportionate burden of disease if you ever expect to realize the potential of your workforce. 

Additional Resource: Check out NCQA's Social Determinants of Health Resource Guide to learn more about equity, disparities, and how you can begin to implement a structured population health conceptual model to better understand, prioritize and address the needs of your workforce.

2.  Redesigning Behavioral Health: To Increase Access to Affordable, High Quality Treatment: Carol Alter, MD of the University of Texas at Austin (bottom center) and Melissa Fitzgerald (top left) of Consumer Medical focused on evidence-based solutions, including Measurement Based Care, Collaborative Care, and high-touch individualized support, that will transform the treatment system and bridge the gap while longer-term behavioral health system fixes are made.

Additional Resources: Learn more about complying with behavioral health parity requirements: (1) Webinar: The Fiduciary's Role in Ensuring Mental Health Access: Looking Beyond Parity  (2) Webinar: DOL MH Parity Enforcement - Implications for Plan Sponsors and The Path Forward  which includes links to pre-reading material including a self-assessment tool!

3.  Redesigning Health & Well-Being: To Achieve Health & Business Results: Ray Fabius, MD (top right) of HealthNext lead a panel discussion with Karen Personett (top right) of DTE Energy, Karen Sones (bottom left) of First Horizon, and Kate Scherkenbach (bottom right) and Becca Kestly (not pictured) of Baird on implementing an evidence-based model that applies rigorous business practices to achieve documented results in health and business performance.

Additional Resources: Get the latest peer-reviewed publication documenting the business performance of employers that have implemented this model and take the HealthNEXT benchmark quiz here to see how you compare.

4.  Redesigning Pharmacy Benefits: To Improve Benefit Performance: Tracy Spencer (top right) of PSG consultants and Josh Golden (bottom center) of Capital Rx, discussed ways employers can effectively manage their pharmacy benefits to improve performance. 

Additional Resource: In addition to pharmacy benefits managed through your PBM, employers need to understand how drugs under their medical plan, which account for about 50% of your drug spend, are being managed. Use this National Alliance of Healthcare Purchaser Coalitions Action Brief and it's employer check list to work with your health plan to achieve value on the medical side of drug benefits.

Posted by Cristie Travis at Tuesday, September 14, 2021

Is the Delta Variant Changing Your Reopening Plans?

As the  Delta variant becomes dominant across the US, including in Memphis and the Mid-South, many employers are re-thinking and changing their reopening plans.

Check out this new decision-support tool from the Health Action Alliance that walks you through key questions you should be asking yourself about you own reopening strategy: 

  • Should I mandate vaccinations for employees?
  • Should I require employees to wear masks?
  • Should I require COVID-19 testing for employees?
  • Should I track or restrict employee travel?
  • How do I manage a partially vaccinated workforce?
  • Can I ask customers for proof of vaccination or deny service to customer that aren't vaccinated?
  • What other public health and safety issues do I need to consider?

For each question the tool provides health, legal and other considerations. 

This is a must-use tool to be sure you have touched all your bases as you finalize your reopening.

In local COVID-19 and COVID-19 Vaccine Employer-Related News:

Here's What Memphis Officials Say About Requiring Vaccinations for Employees 

Germantown Requiring Vaccinations for City Employees

St. Jude Children's Research Hospital Employee Vaccine Mandate FAQs

Christian Brothers University Makes Vaccine Mandatory for Fall

New Health Directive Strongly Urges Masking and Employer Testing of Unvaccinated Employees

Masks Required in Shelby County Government Buildings Open to the Public

MBGH Joins Health Care and Public Health Leaders to Urge Immediate Action to Protect Children from Vaccine-Preventable Diseases


Posted by Cristie Travis at Wednesday, August 4, 2021

COVID Cases on the Rise in Memphis (Again)

As the  Delta variant becomes dominant across the US, including in Memphis and the Mid-South, COVID-19 cases are again on the rise. In Shelby County, the 7-day rolling average of daily new cases was 94 on July 9 and our reproductive rate is now 1.26, the highest it has been since the early days of the pandemic. 

Health officials are predicting over 3,100 cases within the next 30 days. Last week they were only predicting approximately 740 cases.

The good news is that the COVID vaccines remain protective against serious illness and death. The troublesome news is that only 34.7% of Shelby County residents are vaccinated. Shelby County has been named by Georgetown University's US COVID-19 Vaccine Tracking project as one of 5 clusters in the US that could put the entire country at risk of returning to 2020 if we become a breeding ground for new variants.

Approximately 90% of the new Shelby County cases are occurring in non-vaccinated residents. Therefore, your most vulnerable employees are your unvaccinated employees. If you have decided to help educate employees on the benefits of the vaccine and encourage them to be vaccinated, now is the time to double down on your efforts.

Evidence from the Kaiser Family Foundation's COIVD-19 Vaccine Monitor and the Health Action Alliance is shedding light on how employers can effectively increase adoptionClick here for the full article which provides you with specific strategies you can deploy. Highlights of the major findings include: 

  • Employer encouragement and paid time off to get vaccines are working!
  • Mandates are unpopular but could drive adoption rates higher. Of the unvaccinated, 42% of employees say they would get vaccinated if their employer required it, but 50% said they would leave their job.
  • Optimism about the "end of the pandemic" is slowing vaccinations. For example, in Memphis only 764 vaccinations were given the week ending July 10, compared to 1,049 the week before.
  • Vaccine safety remains a primary concern. FDA approval could help address this issue.
  • Incentives that increase ACCESS to vaccines may increase rates and reduce disparities. Incentives could include providing childcare while getting vaccines and offering on-site vaccines.
Posted by Cristie Travis at Tuesday, July 13, 2021

Redesigning for Results: Pharmacy Benefits

Complimentary registrations for All ends July 16 so Register Now!

MBGH members always have complimentary registrations but Register Now to claim your seat before someone else does!

Attendance at our virtual conference will be limited due to platform capacity.

Ask any employer whether they have found the "secret sauce" for managing their pharmacy benefits and the answer is generally "no". The complexity caused by covering drugs in both the prescription drug benefit and medical benefit; contracting and pricing practices that make it difficult, if not impossible, for employers to know if the benefits are being provided and paid for appropriately; and the hodge-podge of buy-up options that are meant to help manage pharmacy benefits but may add to the complexity are just a few of the reasons the answer is "no".

Incremental change on top of a complex platform that may actually need redesigning adds to the frustration.

At our August 26th Annual Conference "Redesigning for Results", Tracey Spencer, Senior VP and Practive Leader-Employer Groups, Labor, Health Systems at Pharmaceutical Strategies Group, and Josh Golden, Senior Vice President Strategy at Capital Rx will help us step back and reimagine the pharmacy benefit, including starting with the end in mind: right drug, right time, right place, right price; examining a market basket of approaches and solutions to help reach this goal; and a candid discussion of the often challenging steps employers need to take themselves to achieve better results.

Check out this Business Insider article focusing on why employers are exploring different PBM models.

Posted by Cristie Travis at Tuesday, July 13, 2021

Executive Order Targets Hospital Consolidations & Price Transparency

President Biden's latest Executive Order issued on July 9, 2021 contains provisions to strengthen reviews of hospital consolidations and continuation of hospital price transparency requirements implemented in the prior administration. 

Consolidation: The order encourages FTC and DOJ to review and revise (e.g.., strengthen) existing merger guidelines so that patients aren't harm, citing that the 10 largest health systems now control approximately 25% of the market; that since 2010 139 rural hospitals have closed; and hospitals in consolidated markets charge a much higher price as compared to hospitals in more competitive markets. Right here in Memphis, the FTC filed a complaint and authorized a suit in federal court to block Methodist's acquisition of Saint Francis citing decreased market competition and the prediction of increased healthcare costs and the diminishment of incentives to expand services, invest in new technology, increase access to care, and focus on quality improvement. Methodist ultimately decided not to move forward with the acquisition. Click here to read the complaint.

Price Transparency:  Effective January 1, 2021, hospitals have been required to publicly report on their website a consumer-friendly list of negotiated prices with health insurance companies for 300 shoppable services as well as a machine-readable detailed listing of all negotiated prices.  The order directs HHS to support these existing requirements. Milliman reports that as of June 2021, approximately 61% of the hospitals had posted the machine-readable files; 33% had posted limited information; and 6% had posted nothing.  Even with these postings, however, much of the information is not presented in a "consumer-friendly" format and is difficult to find, analyze and understand by even the most sophisticated health journalists, as reported by Kaiser Health News. Although it has limitations, the data is shedding light on the variation in negotiated prices across payers within a hospital and across the market.  According the Milliman, the information ultimately can be used for

  • Collecting, transforming, and automating the collection of current and historical payer rates to determine trends
  • Analyzing market position relative to competing providers and payers
  • Comparing hospitals' weighted average reimbursement based on utilization distribution and payer mix
  • Developing direct-to-provider contracts for employers
  • Identifying the financial impact of network types and supporting negotiations
  • Assisting consumers to better understand the cost of healthcare services and episodes along with the impact of out-of-pocket costs

If you would like to see information for Memphis-area hospitals, please email [email protected]. Or, as recommended by KHN, don't hesitate to google the hospital name and "price transparency" and follow the links. 

Posted by Cristie Travis at Tuesday, July 13, 2021

Redesigning for Results: Health & Well-Being

COVID has revealed the fragility of our work environments and workforce, including health and safety protocols; reliance on in-person work; the divide between those that must be on-site vs. those that can work remotely; the challenges of engaging and motivating a remote workforce; and even the re-thinking of the role of work itself for employees and their families. All of this requires more emphasis on supporting employee work/life balance, social connections, mental well-being, financial wellness, and more. These initiatives, typically embedded in health and well-being initiatives, are now creating organizational culture, not just reflecting it. And it is this culture that will attract and retain workers who have many options in this time of a labor shortage (check out changes in the Memphis labor force and why it is becoming so much more competitive here and here).

Since their inception and evolution from wellness programs to a culture of well-being, these initiatives have been relegated to a side-focus of the employer’s health benefits departments. The dedicated benefits and health/wellness professionals in charge of these initiatives have had to constantly support a financial ROI; scourer for free resources; and balance their health/wellness responsibilities with other benefit work.

It is now time to elevate these initiatives and reframe C-suite recognition that the ROI of health and well-being investments isn’t only in reduced health benefit costs, but also in recruitment, retention, and increased productivity. This new frame changes the equation from an expense reduction strategy to a way to increase revenue generated by healthy, engaged, loyal workers. It’s time to redesign these business-critical initiatives to reap the benefits they offer.

Learn how to redesign your health and well-being initiatives to be effective in this new reality at our August 26 virtual conference. Ray Fabius, MD, President and Chief Medical Officer of HealthNext, and a panel of employers currently on this journey, will discuss the use of an evidence-based 10-pillar approach coupled with rigorous business practices to achieve your financial and workforce results and reposition health and well-being programs in your organization.

Attendance at our virtual conference will be limited due to platform capacity. So register NOW for the conference here.

Posted by Cristie Travis at Monday, June 21, 2021

Increasing Vaccine Confidence

 MBGH's April 13 webinar, "Strategies to Increase Vaccine Confidence", shared insights into how to help employees get the credible information they need to make an informed decision on whether or not to get the COVID-19 vaccine. Key insights included: 

Use trusted messengers. Sometimes the most trusted messengers are the “informal” leaders in your organizations that people work with and respect. 

Identify ways to better understand why employees that haven’t gotten the vaccine are hesitant. Knowing this, you can tailor your messages to address the specific concerns your employees have. Can you survey your employees about whether they have gotten the vaccine and if not, why not?

There is power in personal stories about why people have chosen to get the vaccine. Identify employees from across your organization, with consideration that when people see “people like me” share their stories, it resonates more for them.

The “wait and see” group is the most moved by messaging to get the vaccine. The “definitely not” group is not as moved by messaging.

Click here for a copy of the slides from the MBGH session of the webinar which focused on communications strategies to increase vaccine confidence among populations bearing a disproportionate share of the burden for COVID-19.

Use these resources to help plan the next steps in your communication campaign:

KFF COVID-19 Vaccine Monitor: What We’ve Learned (about hesitancy)   Scroll all the way down to see a slide presentation on key takeaways.

THE CONVERSATION: Between Us, About Us This new campaign from KFF’s Greater Than COVID and the Black Coalition Against COVID launches with 50 FAQs designed to dispel misinformation and provide accessible facts about the vaccines from Black health care

Resources for Diversity Professionals and ERG Leaders

A Conversation Guide for Employee Resource Groups, DEI Leaders and Other Employee Networks

Communication Guidance for Businesses 

Toolkit for Black Community

Toolkit for Hispanic Community

Posted by Cristie Travis at Monday, April 26, 2021

Check-In on 2021 Priorities

We're wrapping up first quarter of 2021 so it is a great time to check-in on how MBGH has been addressing our priorities. 

Health Equity

MBGH launched our Health Equity & Benefits initiative with a National Alliance webinar on the NCQA's Multicultural Healthcare Distinction Program. This program identifies organizations that excel in culturally and linguistically sensitive services and work to reduce healthcare disparities. Employers can ask their plans and vendors to follow this road map and get this distinction as an early step in addressing health equity in your benefits. Click here to watch the webinar and get a copy of the slides. Click here to learn more about the Multicultural Healthcare Distinction Program from NCQA. 

Pharmacy Benefit Management

(1) MBGH members participated in a 2-part workshop series focused on eliminating waste in  pharmacy benefits. Using the Purchaser Business Group on Health Removing Waste from Drug Formularies guidebook and Wasteful Drug Spending Savings Calculator to identify specific opportunities they had for savings (email [email protected] for a copy of the calculator). Two similarly sized TN multi-employer organizations each found approximately $500,000 in savings. Click here for results from other employers.

(2) In a webinar, Holmes Murphy highlighted where the hidden profits are for TPAs and PBMs.  An emphasis was placed on "red flags" in both TPA and PBM contracts that are likely resulting in increased costs and/or loss of savings to the employer.  A copy of the highlights from the PBM portion of the webinar will be emailed to MBGH members. MBGH members also have an opportunity for a complimentary 30-day engagement to audit all agreements, conduct risk analysis and assessment, and identify savings opportunities. MBGH members email [email protected] for more information.

Mental Health

The first employer's session for the TN Path Forward for Mental Health & Substance Use initiative focused on a major pain point for employers: high out-of-network use. Darcy Gruttadaro with the APA's Center for Workplace Mental Health explained that network administrative burdens, low reimbursement rates, provider shortages, and inaccuracies in provider directories all contribute to lower in-network use. Click here for a copy of the slides. In addition to addressing these issues, solutions include providing support to in-network primary care physicians that are providing behavioral health care and continuing a robust tele-behavioral health program even after COVID-19.

Posted by Cristie Travis at Tuesday, March 23, 2021

Now You Can Compare Quality and Safety For Outpatient Surgery!

For the first time ever, Memphis-area employers and their employees and families have access to important information on the quality of care for elective outpatient surgery, whether it is provided in a hospital or in an ambulatory surgical center (ASC). This is critical information since 60% of surgeries in the US are now peformed in hospital outpatient deparatments or ASCs.

Eight (8) ambulatory surgery centers (ASC) and 10 hospital outpatient surgery departments (HOPD) in the Memphis-area voluntarily reported this information in response to the Leapfrog Ambulatory Surgery Center Survey and the Leapfrog Hospital Survey.

This joint effort provides purchasers and consumers with information to compare the same procedure, whether offered at a hospital or an ASC, across a range of topics important to purchasers, employers and patients, including:

  • Basic information about the ASC or HOPD
  • Training and education of medical, surgical, and clinical staff
  • Volume and safety of procedures
  • Patient safety practices
  • Patient experience

Click here to get information on Memphis-area ambulatory surgery centers. ASCs reporting this information include Le Bonheur East Surgery Center, Wolf River Surgery Center, GI Diagnostic & Therapeutic Endoscopy Center - Wolf Park, GI Diagnostic & Therapeutic Endoscopy Center - Wolf River, GI Diagnostic & Therapeutic Endoscopy Center - Southaven, Germantown Surgery Center Methodist, Campbell Clinic Surgery Center, and Hamilton Eye Institute Surgery Center. 

Click here to get to hospital information. Select "view ratings" for a hospital and then select those sections for outpatient surgery. Hospitals reporting this information include Baptist Memphis, Baptist Collierville, Baptist DeSoto, Le Bonheur, Methodist Germantown, Methodist North, Methodist University, Methodist South, Methodist Olive Branch, and Regional One.

"This is the first time ASCs have been asked to report this type of information. To have key ASC providers including Campbell Clinic, Gastro One, Methodist Healthcare, and University Clinical Health step up and be willing to share and be held accountable for their quality and safety is outstanding. Of the 9 ASCs reporting in Tennessee, 7 are in Memphis. Of the two ASCs reporting in Mississippi, one is in the Memphis market. Our inaugural reporting rates are a reflection of the leadership of our healthcare community. We anticipate that other Memphis-area ASCs will report as this program continues to grow", said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health. Memphis Business Group on Health is the Leapfrog Regional Leader for west Tennessee, eastern Arkansas, and northern Mississippi. 

Posted by Cristie Travis at Monday, February 22, 2021

Memphis-area Hospitals Out-perform on National Hospital Safety Grades!

In the fall 2020 round of The Hospital Safety Grade, the percentage of Memphis hospitals with an “A” (50%) surpassed the national average (34%)! And, the percentage of Memphis hospitals with an "A" and "B" (70%) also surpassed the national average (58%).  Just three years ago, only 10% of Memphis area hospitals received an "A" and only 20% received an "A" and "B". 

"We are pleased to see this significant momentum in the improvement of Memphis area hospitals' Hospital Safety Grades, especially given the stresses on the healthcare systems due to the COVID-19 pandemic. This type of increase in performance is only possible with a relentless commitment to patient care, quality and safety every day with every patient. Sustained improvement over time results in fewer preventable medical mistakes, less patient and family suffering, and even lower costs." said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health (MBGH). MBGH is the Leapfrog Regional Leader for eastern Arkansas, west Tennessee, and north Mississippi.

In the greater Memphis area, 10 hospitals were graded, and five (5) earned an “A,” two (2) earned a “B,” two (2) earned a “C” and one (1) earned a “D”. No Memphis hospitals earned an “F.” Methodist Le Bonheur Germantown, Methodist North, Methodist Olive Branch, Methodist University and Saint Francis Hospital – Bartlett received an “A”.  Methodist South and Saint Francis Hospital- Memphis each received a “B”.  Regional One was not rated.

For detailed results on all Memphis hospitals click here.

Click here to access safety grades for over 2,600 hospitals nationwide.

Here is a tool kit for employers to use as you evaluate the impact of hospital safety on your health benefit plans and your employees and their families. This toolkit also includes communication material you can share with your employees so they can get the safest care possible.

Posted by Cristie Travis at Monday, February 22, 2021

MBGH 2021 Kick-Off

For the past two years, MBGH programs and activities have focused on a critical health benefit topic: mental health and substance use in 209 and obesity and diabetes in 2020. Being focused in our work has helped our members take action and make significant progress. COVID-19 has exacerbated and made more visible and urgent many issues that we recognize must be worked on simultaneously including increased mental health and substance use needs put on an already broken system; health and healthcare inequities that result for many in our community, especially people of color, carrying an unacceptable health burden; and the need to stop paying for waste and low value care so we can redirect our investments in these emerging priorities. In each of these areas we are focusing on TAKING ACTION and implementing SOLUTIONS to improve the effectiveness of your health benefit programs and services. Here are our 2021 focus areas (you can right-click the image and open in another tab to increase size)

We look forward to working with all of you this year.

Stay well,

Cristie and Janis

Posted by Cristie Travis at Sunday, January 10, 2021

Methodist Le Bonheur Germantown Hospital Named a Top Hospital

Methodist Le Bonheur Germantown Hospital has been named a 2020 Top Teaching Hospital by The Leapfrog Group. The elite award is one of the most competitive honors American hospitals can receive in safety and quality. In order to even be eligible for this Top Hospital Award, hospitals must have an “A” rating on the Leapfrog Group’s Hospital Safety Grade, which Methodist Le Bonheur Germantown Hospital has achieved for the past 4 rounds of the Hospital Safety Grade, including the most recent Fall 2020 results. 

“We are excited and proud that Methodist Le Bonheur Germantown Hospital’s continuous commitment to and achievements in quality and patient safety have been recognized by the Leapfrog Group. On behalf of the 350,000 employees and their families that receive health care benefits through our members across the state, we thank them for the work it takes to perform at this level” said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health. Memphis Business Group on Health is the Leapfrog Regional Leader for west Tennessee, eastern Arkansas, and northern Mississippi, working with providers, purchasers, payors and patients in our area to drive safe, high-quality health care.

“We are honored to receive this competitive award that truly recognizes our unwavering commitment to provide our patients with the safest and highest quality care,” said Methodist Le Bonheur Healthcare  CEO Michael Ugwueke.

The Leapfrog Group is a national nonprofit watchdog organization that rates hospitals on how well they protect patients from errors and infections, as well as the effectiveness of procedures and other care they provide. A total of 105 hospitals were selected as Top Hospitals, including: 9 Top Children’s Hospitals, 29 Top General Hospitals, 19 Top Rural Hospitals and 48 Top Teaching Hospitals.

“We are honored to highlight our 2020 Top Hospitals. Their commitment to transparency, along with patient safety and quality care, helps move the needle in saving lives across the nation,” said Leah Binder, president and CEO of The Leapfrog Group. “The current pandemic has reiterated the importance of putting patient safety first and these hospitals are a great example of that.”

The Top Hospital award is given to teaching, general, rural and children's hospitals that publicly report their performance through the Leapfrog Hospital Survey and meet the high standards defined in the Top Hospitals Methodology. This includes infection rates, maternity care and a hospital’s ability to prevent medication errors, among other standards. To see the full national list of institutions honored as 2020 Top Hospitals, please visit

Posted by Cristie Travis at Friday, January 8, 2021

Act Now To Build on Your Culture of Caring

This year at our annual conference we learned that employees who feel cared about are more engaged and productive. As you continue to build your culture of caring, connecting employees with resources to meet their social needs, such as WIC, as well as community needs, such as Vitalant (formerly LifeBlood) is critical, especially during COVID-19. 

WIC Could Be Right for Your Employees

The economic consequences of restrictions brought on by the COVID-19 pandemic have, undoubtedly, touched many of your employees. Even if they continue to work, their family income may have been negatively impacted resulting in social needs they have not had before. In Tennessee we know that COVID-19 has created an urgent need to connect pregnant and post-partum women, nursing mothers, and at-risk children until their 5th birtday to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A statewide campaign to increase awareness and enrollment has just started and MBGH has joined the effort! Eligibility for WIC is based upon proof of family size, children’s ages, proof of pregnancy (if applicable), and income. For example, income eligibility for a family of four is $48,470. This program may be especially applicable to part-time employees who have limited other family income.  Employees can learn more and complete a pre-screening tool to see if they are eligible at Healthy nutrition feeds the body, cognitive development, and soul and helps prevent obesity and other chronic conditions! Help your employees and their families in need get connected so they can thrive!

The Silent COVID-19 Crisis: Our Blood Supply

Did you know that every unit of blood saves 3 lives? Historically, in normal years, Memphians donated  50,000+ units of blood annually.  Today, Vitalant (formerly LifeBlood) collects a little more than 20,000 units a year.  That's 10,000 fewer lives saved by Memphis donors! As a result, Vitalant imports more than 50% of the blood we need (which cost more and is only available if other communities don't need it) from other Vitalant regions in MS, LA, TX, AZ and NM. Capacity restrictions; fewer mobile blood drives (did you know mobile drives  account for 60% of collections?) because many employees are working from home and students are virtual vs. on campus (did you know 30% of collections come from high school and college students?); as well as concern over contracting COVID-19 in medical settings, have only exacerbated an already fragile blood supply in Memphis. Even in COVID-19 you can sponsor a much needed blood drive: either at one of 5 collection centers or even at the worksite. Vitalant can work with you to design and implement a safe worksite blood drive or if you decide to use their locations, can track employee participation and provide you with the results per drive, per quarter, and/or per year.  People can donate blood every 56 days, so employers can even schedule drives 4-6 times a year (which is turnkey when using the Vitalant locations)! Always remember that you may be saving the lives of your employees and/or their families by working with Vitalant to increase collections. Contact David Williams at [email protected] to explore partnerships and Lawren Bogard at [email protected] for scheduling a blood drive.

Posted by Cristie Travis at Monday, October 19, 2020

Is It Safe to Go to The Doctor in COVID-19?

Guest blog post from Clint Cummins, CEO, and Danielle Hassel, MD, President, Memphis Medical Society

The pandemic has clearly had a dramatic effect on all of us, particularly in the healthcare system, whether you are provider, patient, payer, caregiver, or all of the above. One of the more noticeable effects has been the decrease in the public seeking care for non-COVID-19 illnesses or follow up care for chronic issues.

A recent survey conducted by our partners at Tennessee Medical Association (TMA) reveals that more than half of all doctor’s offices had a 50% or more decrease in office visits and 88% faced decreases in office visits of more than twenty-five percent. Many of the survey respondents were in private practice. These situations are leading many practices to assess their long-term viability. That is not good for the health of our city and state.

So, let’s answer the question: Simply stated, YES, it is safe to go to a doctor’s office! A few precautions should be taken, but they are no more inconvenient than wearing a mask or practicing social distancing.

  1. Call First – there is a possibility your symptoms or condition can be treated via telehealth/virtual care (e.g. telephone or video conference). Your doctor’s office will ask questions to determine whether that is possible.
  2. Know Your Clinic’s Guidelines – some clinics may be located in office buildings with shared tenants or other unique circumstances. Many offer the ability to wait in your car until they are ready to bring you into an exam room. Others offer temperature checks at the entrance to the building. Most clinics will make this information available to you via phone, email or their website. Don’t hesitant to ask. Not all clinics are created equal, so do not hesitate to ask what you need to do in order to ensure the safest appointment possible.
  3. Protect Yourself – wear a mask or face covering to the in-person appointment if available. If you do not have access to a mask, then let the clinic staff know before you walk in. The clinic should be able to provide one for you. Wash hands and use hand sanitizer when given the opportunity. Clinics will use proper screening and safety guidelines to ensure you do not come in contact with patients known by the clinic to be positive for COVID-19.
  4. Protect Others – use your mask to protect others.  Limit the number of individuals who travel with you to your appointment, as they may not all be allowed inside with you.
  5. Know What to Expect for Your Safety
    1. Clinics are keeping suspected contagious cases, especially any threats of COVID-19, completely separated. This may occur through protocols such as seeing only well patients in the morning and sick patients in the afternoon. Then, staff will disinfect the clinic before opening the following day.
    2. The already-stringent cleanliness protocols of practices have only been stiffened during the pandemic. Practices should be disinfecting rooms and equipment thoroughly between patient visits and disposing of biological waste that would be at risk for contamination.
    3. This is reciprocated in the health of and safety of the clinic staff. Clinics do not want to put patients or staff at risk, therefore strict guidelines should be given to staff who should not appear at work if they have fever or suspicious symptoms.  Many clinics go as far as to test employee temperatures daily or enforce regularly scheduled COVID-19 testing of staff.

Most importantly, do not put off necessary care, whether it is in person or via telehealth! If you’re managing a chronic condition such as diabetes or high blood pressure for example, then you should continue to seek care.  If you have a physical injury, you should contact a physician without hesitation.

Our primary concern is the health and safety of our patients and our community – that’s you!

If you need a physician or have questions, go to to find what you need.

Posted by Cristie Travis at Friday, June 26, 2020

Do You Have a Comprehensive Obesity Benefit Design?

According to the American Heart Association, American College of Cardiology, and The Obesity Society, obesity management requires a "stepwise approach" (see chart above).

Benefit design and coverage should align with clinical management to ensure that employees have access to the appropriate clinical services to maximize their opportunity to manage their obesity and be as healthy as possible for as long as possible.

In our historical work with MBGH employers as well as our 2020 focus on obesity and diabetes, we have learned that Memphis-area employers promote cultures of health and wellbeing that support diet, physical activity and behavior therapy. Extensive programs are generally available to support employees in starting and maintaining lifestyle changes. As you see above, these benefits and programs are critical for all levels of body mass index, even when paired with pharmacotherapy and surgery.

We have also found that Memphis-area employers generally cover weight management surgery, subject to significant pre-authorization requirements in order to maximize positive outcomes and lasting impact.

The gap for many Memphis-area employers is offering pharmacotherapy as a covered benefit. As the chart indicates, this management tool is best suited for those wtih a BMI starting a 27 if there are comorbidities and 30 if there are no comorbidities. Also note that pharmacotherapy can be continued for those that undergo surgery.

Results from a randomized trial of lifestyle modifications and pharmacotherapy treatment published in the New England Journal of Medicine in 2005, found that patients with both experienced approximately 2 times the weight loss of those with lifestyle modification alone.

A 2016 study published in Obesity Science and Practice (from the World Obesity and The Obesity Society) indicated that only 1% of the potential 1.8 million potentially eligible patients were receiving pharmacotherapy.

Average weight loss on anti-obesity medications ranges from 3-9%. Weight loss of 5-10% can result in reductions in type 2 diabetes, blood pressure, and blood lipid profile.

Unsure if you you cover pharmacotherapy for your employees with obesity? Here are some steps you can take:

  • Review your summary plan description and specifically the "exclusions" sections to see if you currently cover or exclude anti-obesity medications
  • Examine your PBM contract, including provisions related to the plan design document and/or benefit specification forms. See if you have selected to cover or not cover therapeutic categories that include anti-obesity medications.
  • Check out your pre-authorization requirements and, if you cover or decide to cover anti-obesity medications, check the box that to include appropriate prior authorizaions, which will reduce the likelihood that patients that do not clilnically qualify will receive the medications.

MBGH employer members and members of our Health Benefits Peer Roundtable and Health & WellBeing Peer Roundtable are taking a deep dive into benefit design issues related to obesity. We will be exploring why some employers are not covering pharmacotherapy, how to work with your health plans and PBMs to implement coverage, and employee communications. Contact Cristie Travis at [email protected] for more information on our 2020 focus!

Posted by Cristie Travis at Thursday, May 21, 2020

How will COVID-19 impact your health benefit plan costs?

As we move from crisis control to considering how we operate with coronavirus for the foreseeable future, employers are addressing the economic impact on health benefit plans. Here are some steps you can take:

Understand actuarial projections related to COVID-19 for your specific health plan. Here are some top line findings from Milliman (click here for 2020 report and here for 2021 report):

  • If COVID-19 results in delayed care through June 2020, the net reduction in healthcare costs will be $140-$375 billion nationally. If care is delayed through year end, the net reduction could be $75-$575 billion nationally.
  • 2021 projections differ based on whether or not another wave of the virus results in continued social distancing and deferral of care, if yes, then experience may be similar to 2020 with additional COVID-19 costs being offset by deferred or forgone care. However, if providers demand price increases to make-up for lost revenue in 2020 ,f there is a rush for services due to pent-up demand, and continuation of high COVID-19 treatment costs, 2021 could see significant cost increases.

Remember that if employees have already met their deductible in 2020 they may seek to get delayed care this year, minimizing their out-of-pocket expenses.

Use a dashboard to track trends for complications and downstream costs due to forgone care for those with chronic disease and delayed preventive care, including cancer screening. Include benefits and reminders that can rapidly get them into the care they need. MBGH is using a diabetes dashboard with members this year. Members can email Cristie Travis for a copy.

Remind employees of critical chronic care management and preventive services they need to pay attention to when doctors offices open back up. Refer them to their benefit plan and wellbeing programs for recommendations and coverage.

Consider adding or reinforce existing benefits to support employees in getting the most appropriate treatment for conditions such as hip/knee surgery, lower back surgery, hysterectomy, weight loss surgery. Consider a second opinion benefit if you don't already have one. Delayed elective treatments may have exacerbated physical problems and employees may be seeking immediate care that, at times, may not be the best option. 

Click here to check out the National Alliance's webinar recording and slide deck for the Employer Town Hall on COVID-19: Financial Impact of COVID-19

Posted by Cristie Travis at Thursday, May 21, 2020

Employees With Diabetes & Obesity Are At Higher Risk for Severe Illness

It is clear that your employees with diabetes and obesity are at higher risk for severe illness if they contract COVID-19. Almost 50% of those hospitalized with COVID-19 have obesity and almost 30% have diabetes. In addition, those with obesity and diabetes are at higher risk for hypertension and cardiovascular disease which are also top underlying conditions associated with hospitalization.    

You can support your employees and improve the effectiveness of your health benefits by taking the following actions:

Share the CDC recommendations for actions those at risk can take to help lessen the severity of illness with your employees: See the full-list here. Highlights include: reduce trips to pharmacy by keeping an extra supply of medications at home; be sure influenza and pneumococcal vaccinations are up to date; for those with diabetes, monitor your blood sugar regularly, take your temperature daily, and monitor weight since weight loss may be a sign of high blood sugar; those with severe obesity (BMI 40+) should continue to take medication for underlying conditions (such as hypertension) as prescribed.

Remind your employees of their benefits such as personal health coaching, diabetes disease management programs, advocacy and navigation support, telehealth, and nurse advice lines. Both the CDC and American Diabetes Association stress that effectively managing diabetes reduces the likelihood of severe illness.

Consider first dollar coverage for diabetes (and other chronic conditions) medications, tests, and screenings now IRS-approved for high deductible health plans. Removing the financial barriers to needed care, which can be steep in a high deductible health plan, can help your employees better manage their diabetes. See the IRS expanded list here.

Participate in MBGH's 2020 focus on obesity and diabetes! MBGH employer members and members of our Health Benefits Peer Roundtable and Health & WellBeing Peer Roundtable are eligible to participate. Special projects include working with NCQA on using data to drive strategies; implementing a comprehensive obesity benefit; identifying and filling gaps in benefits and wellbeing programs for those with diabetes; and more. Contact Cristie at [email protected] for more information.

Posted by Cristie Travis at Thursday, April 16, 2020

Your Employees Still Have Other Health Needs

Let's not forget that as much as life seems so different right now, employees still have health needs in addition to those associated with COVID-19. In addition, this global pandemic itself impacts other aspects of your employee's health. Remind your employees of key benefits that will help them navigate through these tough times, such as:

Telehealth: Using telehealth for non-emergent health needs, when appropriate, can keep your employees and their families out of ERs and physician offices where they may be exposed to coronavirus. Avoiding ERs unless it is a true emergency will also help protect that valuable resource for those that need it most, including your employees with strokes, heart attacks, injuries, COVID-19 and other emergent conditions.

EAP, tele-behavioral health, other advocacy/support benefits: The added stress and fear of coronavirus can exacerbate mental health and substance use conditions or, perhaps, even contribute to new ones.  18% of Americans already struggle with anxiety and 61% of employees indicate their mental health impacts their work. Click here to see the World Health Organization's mental health considerations during the COVID-19 outbreak. Click here for a timely article from Employee Benefit News.

Mail order prescriptions: Employees with chronic conditions are at higher risk if infected so must continue to manage their conditions and make healthy choices to stay as healthy as possible. The CDC calls for an "emergency supply" of prescription medications but doesn't specify if that is one or three months. Encourage your employees to talk with their doctor to see if they should increase their one-month supply to three months. Remind your employees of their mail order benefits. Using mail order will help increase social distancing and provided access to needed medications if they have to stay at home for an extended period of time.

Health and wellbeing programs: Physical activity and eating healthy foods have a direct impact on your employee's mental as well as physical health. Other programs that are especially effective for this time include mindfulness, sleep and whole person care. With more employees working remotely, reinforce the programs that are available online and even consider making additional online resources available. Don't forget to deploy strategies to keep your remote employees connected to each other and engaged, perhaps with friendly competitions. Click here to access the slides and additional resources from MBGH's 2019 Annual Conference "Putting It All Together: Physical + Mental Health" to get ideas.

Are there other benefits we should highlight? Email Cristie at [email protected] and we will post them here!

Posted by Cristie Travis at Sunday, March 15, 2020

Check Out National Alliance of Healthcare Purchaser Coalitions Alliance Employer Coronavirus Resources

The National Alliance (NA) employer resource page is updated regulary to keep you abreast of the latest "real world" resources for employers. The National Alliance is focused on bringing us information that is not typically available through other sources, such as what employers are actually doing to prepare for and in response to the ever-changing environment you are operating in! Click here to get:

  • Recording of March 10 Employer Town Hall Call on Coronavirus with the National Alliance Medical Director Advisory Council
  • Toolkits & Guidebooks for employers from CDC, US Chamber of Commerce Foundation, WHO, DOL and more!

Coming Soon! MBGH Members and CEO Culture of Health, watch your email for a PULSE survey about actions you have taken and are considering taking in light of this dynamic environment! Since your submissions are confidential, you will need to let me know if you participate so I can share the results of this national survey with those that submit responses! Don't lose out on this important benchmarking information. We are committed to turning this around quickly so you won't have much time to respond. Please, just one response per organization :) The NA is keeping it short out of respect for your time!

Other Resources

Baker Donelson Webinar Recording: Coronavirus: What Your Business Should Do Right Now

Baker Donelson COVID-19 Website: Click Coronavirus Updates to Know the Latest Developments

US Chamber of Commerce Foundation: Resilience in a Box  Disaster Preparedness and Business Resilience

CDC: Coronavirus Resources for Business and Employers

Posted by Cristie Travis at Sunday, March 15, 2020

We're Postponing Our CEO Culture of Health Awards

Due to recommendations for social distancing to help slow the spread of the coronavirus, MBGH is postponing our annual awards presentation, originally scheduled for April 23. We are currently evaluating our options to identify the best way to recognize your commitment to creating and sustaining a culture of health!

This year we will be recognizing ALL of our CEO Culture of Health participants! It is time to celebrate and recommit to the pledge you made when you joined the initiative to promote and support the health of your employees as a business imperative. The coronavirus pandemic is only reinforcing the need for a healthy and productive workforce and our CEO Culture of Health participants are well positioned to be ahead of the game to weather this volatile time. We will let you know our plans once they are finalized so we can celebrate your accomplishments.

Once again, BlueCross BlueShield of Tennessee and Cigna are sponsoring our awards and we thank them for their continued support.

Posted by Cristie Travis at Saturday, March 14, 2020

MBGH Takes A Deep Dive Into Obesity & Diabetes

In response to MBGH member request, MBGH will be taking a deep dive into obesity and diabetes in 2020.

Our year-long work will provide you with actionable steps you can take to better manage the cost and quality of your benefits and wellbeing programs for those with obesity and/or diabetes. You will:

  • Better understand the benefit and wellbeing implications of obesity being a recognized disease
  • Compare your current benefit and wellbeing offerings to evidence-based and promising offerings that align with the clinical needs of those who are overweight and/or have diabetes 
  • Know whether your employees and their families are receiving evidence-based clinical care through a deep dive into (1) your own data and (2) your health plan's data and benchmarking your experience with others. We're pleased to announce that this data work will be co-led by the National Committee for Quality Assurance (NCQA).
  • Understand how to build the learnings from our 2019 mental health focus into our approach to reduce stigma of obesity and diabetes as well as underlying behavioral health issues.

We will spend a portion of each Health Benefits Peer Roundtable and Health & WellBeing Peer Roundtable focused on obesity and diabetes. Our Annual Awards will have an interactive learning session on this topic and our Annual Conference will address it during several of the break-out sessions. We will augment these meetings with webinars as they arise and other resources.

You can start the Deep Dive today! Use these resources to better understand why obesity and diabetes are important to employers and an overview of key actions you can take:

Obesity: Confronting a Misunderstood and Undermanaged Workforce Disease from the National Alliance for an overview and actions you can take.

St. Louis Area Business Health Coalition Employer Strategies to Address Diabetes to see the list of benefits and programs St Louis employers are deploying. Use this as a checklist to compare your own offerings.

Please don't hesitate to reach out if you have specific areas you want to focus on or to learn more about this initiative.

Posted by Cristie Travis at Tuesday, February 4, 2020

MBGH Selected To Lead Improvements in Mental Health & Substance Use in Tennessee

Memphis, TN – January 6, 2020 – The Memphis Business Group on Health (MBGH), in partnership with HealthCare 21 Business Coalition (HC21) serving middle and east Tennessee, has been selected to lead efforts in Tennessee to improve mental health and substance use care. This is part of a transformative initiative called The Path Forward for Mental Health and Substance Use led by the National Alliance of Healthcare Purchaser Coalitions, American Psychiatric Association (APA), American Psychiatric Association Foundation (APAF) Center for Workplace Mental Health and Meadows Mental Health Policy Institute.

Launched last month, The Path Forward has embarked on a five-year plan to execute a disciplined, private sector approach to improve mental health and substance use care for Americans across the nation.

"Tennessee employers are keenly aware that the behavioral health treatment system in our state is not meeting the needs of their employees and families,” said Cristie Upshaw Travis, MBGH CEO. “Leveraging the collective effort of employers across the state to simultaneously improve in-network access, strengthen effective treatment, and address parity, we can create sustained improvements and Tennesseans can get the care they need and deserve. MBGH is pleased to be selected to engage in this work and to partner with HC21 to achieve this change across the state".

MBGH and HC21 will lead one of eight Regional Employer Stakeholder Engagement Teams (RESET Regions) to leverage the influence of their employer and other health care purchaser members to work with health plans, medical and behavioral health groups, consultants and brokers to combat this public health crisis. To gain national traction, similar efforts are underway in California, Connecticut, District of Columbia, Florida, Kansas, Maryland, Minnesota, New Jersey, New York, Texas, and Virginia.  Funding is being sought for this multi-year effort.

“The mental health and substance use system across the country is in crisis,” said Michael Thompson, National Alliance President and CEO. “The activities of the RESET Regions will be key to achieving and leveraging sustainable and measurable improvements to access, comprehensive care and parity. These employers are the primary financiers of the system and they will both set the tone and hold the stakeholders accountable for accomplishing these goals.”

A report published last month by Milliman found the current state of mental health and substance use treatment in America is dire and only getting worse. Results showed that patients were much more likely to resort to “out-of-network” providers for behavioral health treatment than for other conditions.

To overcome these issues, The Path Forward has identified Five Priority Strategies that constitute our nation’s best opportunity to transform behavioral healthcare at a population level and improve access to necessary early detection and appropriate treatment. These best practices include (1) improving access to “in-network” behavioral health specialists, (2) expanding use of the collaborative care model to integrate behavioral health into primary care, (3) implementing measurement-based care in both primary care and behavioral specialty care to improve quality and outcomes, (4) expanding tele-behavioral health, and (5) ensuring mental health parity compliance.

About Memphis Business Group on Health

Since 1985, MBGH has brought employers, with almost 400,000 covered lives in Tennessee, together to share solutions, make connections, and provide tools to manage the cost and quality of their health benefits. MBGH is the only nonprofit organization in the greater-Memphis area representing the employer’s voice - working to help employers manage the rising cost of health care, improve the quality of medical care, and empower employees and their families to choose healthier lifestyles. Learn more at

About American Psychiatric Association

The American Psychiatric Association (APA), founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,500 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information visit

About American Psychiatric Association Foundation Center for Workplace Mental Health

The American Psychiatric Association Foundation, a subsidiary of the APA, works to create a mentally healthy nation by advancing mental health, overcoming mental illness and eliminating stigma. The Center for Workplace Mental Health helps employers create a more supportive workplace for their employees and advance mental health at their organizations For more information, visit

About Meadows Mental Health Policy Institute

Since its public launch in 2014, Meadows Mental Health Policy Institute (MMHPI) has helped Texas legislators, government officials, members of the judiciary, and local leaders identify systemic mental health needs and solutions, quickly becoming Texas’s most trusted source for data-driven mental health policy. MMHPI is helping Texas leaders address the mental health crisis in our jails and emergency rooms, improve access to care for veterans and their families, shift the focus of new investments toward early intervention, and expand the mental health workforce. Learn more about MMHPI at

About National Alliance

The National Alliance of Healthcare Purchaser Coalitions is the only nonprofit, purchaser-led organization with a national and regional structure dedicated to driving health and healthcare value across the country. Our members represent more than 12,000 employers/purchasers and 45 million Americans spending over $300 billion annually on healthcare. To learn more, visit, connect with us on Twitter and LinkedIn.

# # #

Media Contact:

Cristie Upshaw Travis

Email: [email protected]

Telephone: 901-487-7299

Posted by Cristie Travis at Monday, January 6, 2020

MBGH CEO Elected Vice President of National Quality Forum Board of Directors

Memphis, TN – January 6, 2020 – The National Quality Forum (NQF) announced on January 3, 2020, Jonathan B. Perlin, MD, PhD, MSHA, President, Clinical Services and Chief Medical Officer of Hospital Corporation of America as the new chair of its Board of Directors and Memphis Business Group on Health Chief Executive Officer Cristie Upshaw Travis as Board vice chair.

“NQF has the unique ability to pull together the diverse voices necessary to provide the collective perspective to chart the path for improving the quality of care in our country,” said Dr. Perlin. “It is an honor to work with such a committed group of colleagues to advance a mission to improve healthcare outcomes for every person in every community.”

"I am honored to join my fellow Tennessean, Jon Perlin, in working with the National Quality Forum Board of Directors and strong NQF team to continue NQF's work to drive measurable health improvements through collaboration, leadership, passion, excellence and integrity".

Ms. Travis' has been involved with NQF for over 10 years and served as Treasurer of the Board of Directors; Vice Chair and Chair of the Consensus Standards Approval Committee; is co-Chair of the Admissions/Readmission Standing Committee; and is rolling off as co-Chair of the Hospital Workgroup for the Measures Application Partnership. Ms. Travis also serves on other national boards and committees, including serving as Chair of the Board of Governors for the National Alliance of Healthcare Purchaser Coalitions; Vice Chair of the Board of Directors for The Leapfrog Group; and as a member of the Employer Advisory Council for the National Committee for Quality Assurance (NCQA).

NQF also announced seven new members of its Board of Directors encompassing diverse private and public healthcare leaders from across the country.

“The diverse composition of our Board is central to NQF’s commitment to drive multiple perspectives into actions that create measurable health improvements for every person,” said NQF President and CEO Shantanu Agrawal, MD, MPhil. “We are excited to enter the new year with Board members focused on tackling national health needs.”

The new NQF Board members include:

Jeffrey Brady, MD, MPHDesignee for Gopal Khanna, MBA, Director, Agency for Healthcare Research and Quality (AHRQ)

Dr. Brady has served as the Director of AHRQ's Center for Quality Improvement and Patient Safety since 2014. He is as a member of the AHRQ Senior Leadership Team and leads a part of the Agency that conducts several AHRQ programs, including: Patient Safety Research, Healthcare-Associated Infections Prevention, Patient Safety Organization Program, National Healthcare Quality & Disparities Report (NHQDR) Program, and measurement initiatives such as the AHRQ Quality Indicators and the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey resources. Before moving to AHRQ in December 2006, Dr. Brady served as a medical officer and clinical reviewer for the Food and Drug Administration's Office of Vaccines. Additionally, he has held positions as a medical epidemiologist for the Department of Defense and primary care physician in the U.S. Navy.

Susan B. Frampton, PhDPresident, Planetree International

Dr. Frampton is President of Planetree International, a non-profit advocacy and membership organization working to implement person-centered models of care. She speaks internationally on culture change and the patient experience. In 2009, Dr. Frampton was named one of “20 People who Make Healthcare Better” by Health Leaders Magazine. She has authored numerous publications, including the three editions of Putting Patients First (Jossey-Bass 2004, 2008, 2013), and served as lead author on the National Academy of Medicine’s Harnessing Evidence and Experience to Change Culture, released in early 2017.

Garth Graham, MD, MPH, FACP, FACCVice President of Community Health & Impact, CVS Health, President, Aetna Foundation

Dr. Graham is a cardiologist, public health expert, and a leading authority on social determinants of health. He oversees the community health initiatives for CVS Health, bringing his experience as a former deputy assistant secretary at the U.S. Department of Health and Human Services under the Obama and Bush administrations, where he also ran the Office of Minority Health.

Thomas Kottke, MD, MSPHMedical Director for Well-being, HealthPartners

Dr. Kottke is a clinical cardiologist in HealthPartners Medical Group and a researcher at the HealthPartners Institute for Education and Research in addition to serving as Medical Director for Well-being at HealthPartners. He is board certified in internal medicine and the treatment of cardiovascular diseases and holds the academic rank of Professor of Medicine at the University of Minnesota.

Kameron Leigh Matthews, MD, JD, FAAFPDeputy Undersecretary for Health for Community Care, Department of Veterans Affairs

Dr. Matthews is a board-certified family physician, advocate, and policy maker with a career focus on underserved patient populations. Overseeing a national budget of more than $14 billion, she is responsible for the community-based provider network and services that increase access to care for Veterans and select family members nationwide, as well as the associated business processes including claims operations and management, revenue cycle, and quality oversight. In 2017 she was named one of National Minority Quality Forum’s 40 Under 40 Leaders in Minority Health.

Shannon Connor Phillips, MD, MPH, FAAP, SFHMChief Patient Experience Officer, Intermountain Healthcare

Dr. Phillips leads the office of patient experience at Intermountain Healthcare, the largest integrated healthcare delivery system in the Intermountain West, a team catalyzing safety, quality, and experience of care. In 2018, she was named to Becker’s Hospital Review’s 30 Hospital and Health System CXOs to Know list. Her vision is that healthcare is an empathic and effective human experience. Prior to joining Intermountain, she served as Cleveland Clinic’s first patient safety officer and as associate chief quality officer.

Lisa WoodsSenior Director, U.S. Strategy & Design of Benefits for Walmart Stores, Inc.

Woods is a nationally recognized innovator and thought leader in healthcare. She was named to Fortune magazine’s World’s Greatest Leaders (#10) in 2019 as a result of her efforts for driving and influencing positive change in the healthcare industry.

Click here to see the full NQF Board of Directors roster.

Posted by Cristie Travis at Sunday, January 5, 2020

Continued Upward Momentum in Memphis Hospital Safety Grades

In the fall 2019 round of The Hospital Safety Grade, the percentage of Memphis hospitals with an “A” (40%) continued to surpass the national average (33%)! And, the percentage of Memphis hospitals with an "A" and "B" (60%) also surpassed the national average (58%).  Just two years ago, only 10% of Memphis area hospitals received an "A" and only 20% received an "A" and "B". 

"We are pleased to see this continued momentum in the improvement of Memphis area hospital's Hospital Safety Grades. Sustained improvement over time results in fewer preventable medical mistakes, less patient and family suffering, and even lower costs," said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health (MBGH). MBGH is the Leapfrog Regional Leader for eastern Arkansas, west Tennessee, and north Mississippi.

In the greater Memphis area, 10 hospitals were graded, and four (4) earned an “A,” two (2) earned a “B,” five (5) earned a “C.”  No Memphis hospitals earned a "D" or an “F.” Methodist Le Bonheur Germantown, Methodist University Hospital, Saint Francis Hospital – Bartlett, and Saint Francis - Memphis  received an “A”. Methodist North Hospital and Methodist South Hospital each received a “B”.  Methodist University, Methodist South, and Regional One increased their grades from the spring 2019 release. Methodist Olive Branch did not have sufficient information to receive a grade.

For detailed results on all Memphis hospitals click here.

The fall 2019 Hospital Safety Grade release coincides with the 20th anniversary of the Institute of Medicine's To Err is Human report which focused the nation's attention on the nearly 100,000 deaths a year due to preventable medical mistakes. A recent analysis from The Johns Hopkins Armstong Institute for Patient Safety and Quality found that 45,000 fewer deaths occurred in 2018 compared to 2015, based on the prevalence of safety problems in hospitals receiving a Leapfrog Hospital Safety Grade.

 “The findings of the IOM report, published two decades ago, laid the foundation of what The Leapfrog Group stands for today,” said Leah Binder, CEO of The Leapfrog Group. “We commend others who have joined us in the drive for transparency, including the Centers for Medicaid & Medicare Services, which commits to public reporting of safety data, employers and payors, who put appropriate pressure on facilities to make performance data available, and hospitals that publicly report on their safety and quality.”

Click here to access safety grades for over 2,600 hospitals nationwide.

Here is a tool kit for employers to use as you evaluate the impact of hospital safety on your health benefit plans and your employees and their families. This toolkit also includes communication material you can share with your employees so they can get the safest care possible.

Posted by Cristie Travis at Monday, December 2, 2019

Want to Reduce Waste in Health Benefits?

A meta-analysis of 54 peer-reviewed publications, government reports, and the "gray literature" estimates that 25% of total healthcare spending can be classified as waste ( Shrank WH, Rogstad TL, Parekh N. Waste in the US Health Care System: Estimated Costs and Potential for Savings. JAMA. Published online October 07, 2019. doi:10.1001/jama.2019.13978; accessed 10/10/19).

This publication advances our understanding of where this waste is actually occurring, potential savings, and even actions that can be taken to reduce waste.

The following charts use the highest estimates of waste and potential savings (estimated at a conservative 25% of waste) to help us target waste-reducing actions that are both impactful and practical. Note, the literature did not estimate potential savings for administrative complexity.

The interventions with the highest potential savings most applicable to employer actions include:

  • Integration of behavioral and physical health
  • Care coordination in Accountable Care Organizations
  • Transitional care programs
  • Optimizing medication use
  • Insurer-based pricing interventions (through actions such as standardized pricing; negotiations; value-based design and purchasing)

What can you do?

  • Get a copy of the full article here (you may need to pay a fee) to see the complete list of areas of potential savings. MBGH employer purchaser members check with [email protected] for additional details prior to accessing the article.
  • Evaluate the effectiveness of the waste-reduction strategies you already have in place. Where do those strategies fall on the complete list? Are they working? If not, can you identify why? What tweaks need to be made?
  • Identify the high impact interventions listed above that you are not addressing. Consider actions you can take and develop implementation plans.

MBGH can assist our employer purchaser members understand more of the applicable findings of this publication and in these steps. We will also explore best practices and share current approaches to these high priority interventions with each other in our Health Benefits Peer Roundtable and Health & WellBeing Peer Roundtable. Reach out to [email protected] for more information. 

Posted by Cristie Travis at Thursday, October 17, 2019

On the Minds of Health Benefits Managers: Health Plan Design and Management Tips

Questions abound as health benefits managers rise to meet the challenges of changing health landscape, so we sat down with Joseph McCool, Principal of The McCool Group and moderator of the Employer Panel at Validation Institute’s Memphis Health Care Benefits Summit, to talk through some of the hot-button topics we’ve heard from employers while out on the road.

  1. Ensure employees have access to outcome-driven primary care physicians to reduce costs over time

Healthcare management is rapidly expanding, putting new tools in the hands of both HR professionals and employees. “At an enterprise level,” Mr. McCool explained, “it means instituting controls such as pre-authorization for medical procedures. At the individual employee level, it means offering biometrics services to help individuals understand their current risk factors for disease and illness.”

Awareness of these risk factors is only the first step, however. To reduce costs over time, individuals need to work with outcome-driven primary care physicians, and employers need to ensure that employees have access to those quality health care providers under their health plan.

  1. Communicate why changes in healthcare coverage are needed

According to Mr. McCool, transparency with employees is key: “You may not satisfy everyone, but you have to make a concerted effort to communicate why changes in healthcare coverage are needed and draw the line on change initiatives that would fundamentally alter the broader employer-employee relationship.” You can’t control what your company can afford, but you can control the way you explain it to those most affected, and do your best to ensure employees feel heard and appreciated.

  1. Engage with advisors, including business coalitions, to better understand the impact of cost-reduction strategies on the company and the employee

While benefits brokers, as Mr. McCool explains, can do much of the heavy lifting to piece together multiple options to manage spend and expand offerings that makes sense, working with local and national organizations like the Memphis Business Coalition on Health, rounds out your decision-making. These organizations are great sources for networking and also provide an opportunity to share ideas and lessons learned. Most importantly, they’re focused on helping its members take the flood of knowledge they receive from meetings, news articles, and other advisors and channel it all into meaningful, actionable steps.

  1. Demonstrate to employees that how they procure healthcare services impacts the cost of their insurance

Conversations about usage, preventive care, and outlining the benefits of the various services you offer, like telemedicine, are highly valuable but often overlooked. “If employees who don’t regularly go for physical exams continue using the local Emergency Room as a catch-all for every health issue, those costs will really stack up on the employer,” Mr. McCool advises. “Putting highly individualized health information into the hands of employees is a first-step toward managing costs and convincing employees that healthcare cost management can help preserve their jobs and the future of the company that employs them.”

The stress of benefits administration can be significantly reduced by understanding the resources available to you, finding trusted partners and colleagues to help guide you through the process, and empowering employees to take their healthcare by the reins to be an essential part of the solution.

To learn more about these topics, sign up for Validation Institute’s upcoming Memphis Health Care Benefits Summit. MBGH members, CEO Culture of Health participants, and Annual Supporters should contact [email protected] for the special registration link to receive your discount.

Posted by Cristie Travis at Tuesday, June 4, 2019

Memphis Surpasses National Average for "A" Hospitals

In this round of The Hospital Safety Grade, the percentage of Memphis hospitals with an “A” and “B” increased from 46% to 55%. Last year at this time only 20% of Memphis hospitals had an "A" and "B". Memphis now surpasses the national average (32%) with 36% of our hospitals receiving an "A".

In the greater Memphis area, 11 hospitals were graded, and four (4) earned an “A,” two (2) earned a “B,” four (4) earned a “C,” and one (1) earned a “D”. No Memphis hospitals earned an “F.” Methodist Le Bonheur Germantown, Methodist Olive Branch Hospital, Saint Francis Hospital – Bartlett, and Saint Francis - Memphis  received an “A”. Methodist North Hospital and Methodist University Hospital each received a “B”.

For detailed results on all Memphis hospitals click here.

"With 36% of our hospitals receiving an "A", Memphis is now above the national average of 32% and we are much closer to the national benchmark of 58% of the hospitals receiving an “A” or a “B”. Clearly this is good news! We are seeing some movement of hospitals between grades, but this type of movement has occurred in the past before grades became more predictable and sustainable.  Safety is not a one-and-done; it results from a culture that insists on safety every day for every patient. MBGH looks forward to seeing these improved grades sustained over time. We will then be confident that the improvements are foundational and long lasting.” said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health, the Regional Leader for The Leapfrog Group for the Memphis-area, and Vice Chair of The Leapfrog Group Board of Directors.

Alongside its semiannual Leapfrog Hospital Safety Grade update, Leapfrog contracted with The Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine to update its estimate of deaths due to errors, accidents injuries and infections at “A”, “B”, “C”, “D” and “F” hospitals. Researchers assessed more than 2,600 hospitals receiving Hospital Safety Grades and found that when compared to “A” hospitals patients at “D” and “F” hospitals face almost double (92% greater) risk of death. This reseach shows that compared to an "A" hospital your risk of dying increases 34.9% in a "B" hospital; 87.7% in a "C" hospital; and 91.8% in a "D" and "F" hospital (combined. If every hospital had the performance of an “A” hospital, an estimated 50,000 lives saved could be saved. Overall, the researchers concluded that an estimated 160,000 lives are lost annually due to avoidable medical errors that are accounted for in the Leapfrog Hospital Safety Grade. See the report and infographic here.

These results reinforce the urgency in Memphis area hospitals continuing to improve the safety of care they provide. Memphians deserve to have the safest hospital care in the country. It seems we are on the right track, but still have work to do. Memphis Business Group on Health is committed to working together with our hospitals to achieve this as quickly as possible.

Click here to access safety grades for over 2,600 hospitals nationwide.

Here is a tool kit for employers to use as you evaluate the impact of hospital safety on your health benefit plans and your employees and their families. This toolkit also includes communication material you can share with your employees so they can get the safest care possible.


Posted by Cristie Travis at Wednesday, May 15, 2019

Implement a Mental Health Strategy

Over 80 stakeholders participated in MBGH's April 24, 2019 session designed to explore the components of a comprehensive worksite mental health strategy. Moving from component to component in small groups gave attendees a chance to share and learn from each other and think strategically about how to design benefits and well-being programs to support emotional health.

Take these steps to implement a comprehensive mental health strategy and consider adopting actions shared by other Memphis-area employers at our session!

(1) Know the Impact: Use wellness champions to understand personal impact on employees; include questions on employee surveys; track reasons for EAP utilization; analyze health benefit claims (medical and pharmacy); 

(2) Break the Silence: Hold lunch-n-learns and seminars; provide management training; offer mindfulness/resilience programs; coordinate with HR policies/procedures

(3) Provide Access to Affordable, High-Value Care: Offer some provider visits at no cost; provide tele-behavioral health; coordinate vendors for cross-referrals; communicate frequently the resources that are available

(4) Build a Culture of Well-being: Use the term "emotional health" vs "mental health"; elevate recognition and status of wellness champions and councils; provide health coaches; coordinate with community organizations

Since May is Mental Health Awareness Month, what better time than this to evaluate your mental health strategy to be sure you are addressing all four of these components!

Check out mental health resources to help you implement a strategy on MBGH's blog here

Posted by Cristie Travis at Monday, May 13, 2019

What About Mental Health and Substance Use Spend?

The spend picture for inpatient mental health and substance use looks different. Spend is being driven by both an increase in utilization and an increase in price.

Inpatient substance use increased utilization (18%) combined with significant prices increases (39%) increased spending per person by 64%! Inpatient mental health utilization remained relatively stable until 2017 when it increased 6%. A 14% increase in prices resulted in a 20% increase in spend.

MBGH's evaluation of the Addiction Recovery Medical Home with an alternative payment model, is designed to address rising spend that is very often not even accompanied by sustained recovery. Email [email protected] to learn more about this initiative.

Posted by Cristie Travis at Thursday, April 18, 2019

Really Want to Control Your Health Spend?

1) Understand that price is the major driver behind spend. The Health Care Cost Institute's 2017 Health Care Cost and Utilization Report found that the total cumulative change in price from 2013-2017 was a 17.1% increase while utilization remained relaitvely stable. Overall spend increased 16.7% for this same time period. 

(2) Continue effective traditional approaches to control cost. Willis Towers Watson's 2018 23rd Annual Best Practices in Health Care Employer Survey found employers taking these steps:

  • Concentrating on clinical conditions that drive high-cost claims
  • Better managing pharmacy, especially specialty pharmacy
  • Increasing utilization of centers of excellence, telemedicine, and high-performing networks
  • Evaluating "low point-of-care cost plans" as an option
  • Focusing on employee total "well-being"

You might think that the most effective way to decrease spend is to reduce the amount of care needed and used. But the industry has traditionally responded to utlization decreases with price increases resulting in keeping themselves "whole" and increasing your spend. 

(3) Pair effective traditional cost control approaches with explicit price control/reduction strategies, such as Medicare contracted reference-based pricing (i.e., no balance bill to patient). Other new payment models, such as bundled pricing, captitation, and global payments may also stem the tide of rising prices, but only if the negotiated price is set at a fair level and subject to resetting over time.

(4) Shift care to lower-price sites of care, such as home dialysis, freestanding infusion centers, ambulatory surgery centers.

These are just a few strategies that you should consider adding to your spend management. 

Posted by Cristie Travis at Thursday, April 18, 2019

Are Flawed Denial Guidelines Being Used for Your Behavioral Health Coverage?

A recent court ruling found that United Behavioral Health (UBH), a division of United Health Group, used overly strict criteria for denying care, potentially excluding significant number of members, including children and adolescents, from accessing behavioral health services. Specifically, the court ruled that UBH violated it's fiduciary responsibilities and also failed to recognize chronic and complex behavioral health conditions and needs.

Read the article  on the court's ruling from Health Payer Intelligence.

What can you do to better understand the denial guidelines, and other policies, used by your health plan or behavioral health manager? Here are some suggestions:

Re-evaluate the results of the National Alliance's mental health deep dive in light of this ruling. Pay special attention to the section on Accreditation and Parity (page 14) to better understand that parity also applies to non-quantitative treatment limitations. The call-out box specifically refers to medical management standards limiting or excluding benefits. Check with your legal counsel and advisors re: the implications of excess denials re: these parity requirements.

Check out proposed FAQ's from HHS, DOL, Treasury on parity and the 21st Century Cures Act. 

Use this form to collect data on your actual denial rates. Compare behavioral health to medical/surgical denial rates to get a clear picture of this issue for your organization.

Use this model language and consider seeking indemnification from your vendor for certain aspects of parity non-compliance. 

Contract with an objective third-party vendor to audit parity compliance. Memphis area results from the national employer survey on mental health indicate that few external audits are being conducted.

Posted by Cristie Travis at Tuesday, March 19, 2019

How Ending Medicare Drug Rebates Impacts You

Check out these resources to get a clearer picture of how the Trump Administration's proposed regulations ending drug rebates for Medicare Part D plans and Medicaid managed care plans (assuming they are finalized) impact you. 

HHS Fact Sheet on the Proposed Reguations: Check out the section on "What This Means for Private Plans" for the nuances of OIG rules and possible impications for you.

Modern Healthcare "Azar Suggests Commercial Plans Will Ditch Rebates Too" Secretary Azar calls out several reasons private payers are likely to follow Medicare's lead.

For more background information:

Better understand who is likely to benefit (and who is not) from rebates going away on Kaiser Health News

Focus on the purchaser perspective of the Trump Administration's evolving drug policy. Note the potential negative consequences for you if similar changes are not made in the private sector. Michael Thompson, CEO of the National Alliance of Healthcare Purchaser Coalitions, summarizes why ending rebates would benefit employer purchasers here and here.

Refresh your memory on how rebates work and The Impact of Prescription Drug Rebates on Health Plans and Consumers. There is a lot of detail here but for the bottom line focus on the Executive Summary and Background and those sections that specifically address private insurance. Interesting to note that $23Billion was paid out in rebates to private health plans in 2016, which is 12% of point-of-purchase spending. Generally rebates reduce the net cost of the health benefit and are reflected in lower premiums.

Posted by Cristie Travis at Thursday, February 14, 2019

Are Your Mental Health Benefits Effective?

Employers play a critical role in promoting and supporting employees and their families mental health as it impacts productivity, health status, quality of life, and health benefit costs.  MBGH believes it is important for mental health and well-being to sit equally along-side physical health.

In 2019 MBGH is focusing on understanding how Memphis employers are addressing mental health in your health benefits and well-being programs and we are offering specific training and learning sessions to assist you in enhancing the effectiveness of these benefits.

As part of this focus, here are some actions you can take now:

FOR MEMPHIS-AREA EMPLOYERS ONLY: Take this national survey of current employer attitudes and future directions re: mental health strategies. Survey participants get national results for benchmarking and MBGH will get a market-specific report to inform actions to help make your mental health strategies even more effective. Please respond by January 16, 2019Click here for a .PDF copy of the survey questions for your review. Please indicate you are a member of Memphis Business Group on Health. We ask that only one survey be submitted per organization so please coordinate with your co-workers on who will submit the survey.

Get templates and suggested contract language to strengthen your contracting practices related to mental health parity. 

•  Mental Health Parity Model Hold-Harmless Language

•  Mental Health Parity Model Data Request

Check-out these reports for critical information and steps employers are taking to effectively manage the cost and quality of their mental health benefits. 

•  Mental Health Deep Dive Report (see employer checklist in Appendix 1)

•  Mental Health Action Brief

•  AHA CEO Roundtable Mental Health

Participate in the mental health events detailed below and throughout the year that will provide you with specific actions you can take in the workplace.

Posted by Cristie Travis at Monday, January 7, 2019

Purchasers Guide to PBM Quality 2018 Gives Employers Critical Performance Data

The "Purchasers Guide to PBM Quality 2018" from MBGH and the National Alliance of Healthcare Purchaser Coalitions reports on comparative performance of PBMs; provides special reports on cutting-edge PBM practices; and gives you specific action steps you can take now to improve pharmacy benefit cost and quality.  

The blinded public report can be used by employers as a discussion guide with your PBM to explore and benchmark their performancce as well as set expectations for future improvements.

MBGH employer members can get an UNBLINDED report revealing specific PBM performance by emailing Cristie Travis at [email protected] 

Participating PBMs cover over 119 million covered lives and include:

  • BeneCard PDF
  • Cigna
  • CVS Health
  • Express Scripts
  • Maxor Plus
  • Navitus
  • OptumRx
  • Perform Rx
  • United Health Care

Specific areas of importance to employers that are reported include (1) specialty pharmaceutical management, (2) outpatient quality, safety, and adherence, (3) efficiency, (4) pharmaceutical support: CAD, diabetes, mental health, (5) pharmaceutical support: tobacco, obesity, (6) program organization, (7) cultural competency, (8) price transparency, and (9) business practices.

 Click here for a copy of the public report.

Posted by Cristie Travis at Tuesday, November 27, 2018

More Memphis Hospitals Earn Top Scores on Hospital Safety Grade

In this round of The Hospital Safety Grade, the percentage of Memphis hospitals with an “A” and “B” increased from 20% to 46%. 

In the greater Memphis area, 11 hospitals were graded, and two (2) earned an “A,” three (3) earned a “B,” five (5) earned a “C,” and one (1) earned a “D”. No Memphis hospitals earned an “F.” Methodist Olive Branch Hospital and Saint Francis Hospital – Bartlett both received an “A”. Baptist Memorial Hospital Memphis, Methodist Le Bonheur Germantown Hospital, and Saint Francis Hospital - Memphis each received a “B”.

For detailed results on all Memphis hospitals click here.

"Memphis is now much closer to the national benchmark of 56% of the hospitals receiving an “A” or a “B”. However, our market still has work ahead of us to reach benchmark and, as we would all want and Memphians deserve, surpass it and become a national leader in safety.  Safety is not a one-and-done; it results from a culture that insists on safety every day for every patient. MBGH looks forward to seeing these improved grades sustained over time. We will then be confident that the improvements are foundational and long lasting. On behalf of Memphis employers, purchasers, and patients, we are committed to working together to make Memphis the safest community in America,” said Cristie Upshaw Travis, CEO of the Memphis Business Group on Health, the Regional Leader for The Leapfrog Group for the Memphis-area.

The Leapfrog Group, a national nonprofit aiming to improve health care quality for consumers, employers and purchasers, announced today the fall 2018 Leapfrog Hospital Safety Grades. The independent grading system assigns “A,” “B,” “C,” “D” and “F” letter grades to general acute-care hospitals in the U.S. based on their ability to protect patients from avoidable errors, injuries, accidents and infections.

In the wake of the high stakes mid-term election, neither party can claim victory in addressing preventable errors and infection in hospitals. The fall 2018 Leapfrog Hospital Safety Grades show that 33 percent of hospitals in traditionally blue states and 32 percent of hospitals in traditionally red states earned “A’s.” As recently as September 2018, The Leapfrog Group testified at a hearing of the United States’ Senate Health, Education, Labor, and Pension (HELP) Committee, chaired by Tennessee’s Senator Lamar Alexander, offering guidance for a bipartisan approach to improving transparency of patient safety data and making progress on safety.

“The Hospital Safety Grades give the American public information they need and deserve about the safety of their hospitals. Avoidable medical errors and infections in hospitals are still the third leading cause of death in the nation, and that’s not a partisan issue,” said Leah Binder, president and CEO of The Leapfrog Group. “We commend Memphis Business Group on Health for making this a priority.”

Developed under the guidance of a National Expert Panel, the Leapfrog Hospital Safety Grade uses 28 measures of publicly available hospital safety data to assign the grades to more than 2,600 U.S. hospitals twice per year. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public.

For more information about the Leapfrog Hospital Safety Grade, as well as individual grades and state rankings please visit and follow The Leapfrog Group on Facebook and Twitter. Journalists interested in scheduling interviews should email [email protected]

About Memphis Business Group on Health

Since 1985, Memphis Business Group on Health (MBGH) has brought employers, with approximately 375,000 covered lives in Tennessee, together to share solutions, make connections, and provide tools to manage the cost and quality of their health benefits in an ever-changing environment. MBGH accomplishes this by providing access to critical market data, facilitating best practice sharing among the areas leading employers, and offering practical tools for successfully managing health benefits and creating cultures of health in the workplace. MBGH has been a Regional Leader for The Leapfrog Group since 2002.

About The Leapfrog Group

Founded in 2000 by large employers and other purchasers, The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. The flagship Leapfrog Hospital Survey collects and transparently reports hospital performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions. The Leapfrog Hospital Safety Grade, Leapfrog's other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents, and infections.


Posted by Cristie Travis at Thursday, November 8, 2018

It's Time To Better Manage Your Mental Health Benefits

Two recent publications from the National Alliance of Healthcare Purchaser Coalitions make it clear that there is much work to be done to improve the cost and quality of mental health services and to deliver on the promise of parity of mental health with physical health benefits. These publications provide employers with specific actions you can take internally and with your mental health services vendors to start the work.

Use the National Alliance's latest Action Brief "Mental Health: Accelerating Action for Parity and Peak Performance" as a checklist of employer best practices; compare what you are doing now; and identify actions you need to take to better manage the cost and quality of your mental health benefits. This Action Brief (click here) lays out specific actions employers should take to (1) Know the Impact, (2) Break the Silence, (3) Ensure Parity and Affordable Access, and (4) Build a Culture of Wellbeing that includes mental health. 

Meet with your health plan or behavioral health organization (BHO) about how they performed on critical purchaser requirements for mental health benefits and services in the National Alliance's report "Achieving Value in Mental Health Support: A Deep Dive Powered by eValue8" (click here for report). MBGH members have been sent codes to unblind the report. If you need another copy, please email [email protected] 

Both of these resources reveal that there is significant work that employers can do internally (Action Brief) and that health plans and BHOs can do (Deep Dive). Using the resources together gives you an understanding of the total picture and a pathway to more effectively manage the cost and quality of your mental health benefits.

Posted by Cristie Travis at Tuesday, October 2, 2018

Hospitals Have Bar Code Medication Administration But Don't Always Use It Right

A recent report from The Leapfrog Group and Castlight shows that only 1/3 of the hospitals fully-met Leapfrog's standards for bar code medication administration. Get a copy of the report here.

Most surprising, and very dangerous from a patient safety perspective, was that 42% of the hospitals were failing to scan BOTH the patient and the medication 95% of the time!

Memphis hospitals, on average, reflect this national experience, with 40% of our hospitals not meeting the 95% standard.

Note: Baptist Memorial Health Care Corporation hospitals did not report. They will report this year so we will have this information for them in the summer.

Use the report to educate your employees about the steps that should be taken for bar code medication administration to protect their safety! Especially tell your employees to be sure that when given medication, both the patient and the medication are scanned!

Click here to see how Memphis-area hospitals scored on other aspects of bar code medication administration.

Posted by Cristie Travis at Wednesday, June 6, 2018

To Err is Human Screening Spurs Community Dialogue on Patient Safety

On Friday, May 25, 2018, the Memphis healthcare community gathered for a screening of To Err is Human: A Patient Safety Documentary, followed by a panel discussion about shared solutions to reduce preventable medical mistakes among health care organizations throughout the Mid-South.

Hosted by the Memphis Business Group on Health, Southern College of Optometry, and the Memphis Medical District Collaborative, the event featured a sneak preview screening of Mike Eisenberg’s film To Err is Human. The film, set to be released in November 2018, explores the United States’ third-leading cause of death: medical mistakes, which lead to as many as 440,000 preventable deaths each year. It also follows Sue Sheridan, whose family experienced a variety of medical errors that caused long-term health issues.

Cristie Upshaw Travis, Chief Executive Officer of the Memphis Business Group on Health (far left) and Lewis Reich, President of Southern College of Optometry (far right) welcomed the filmmakers, Mike Eisenberg, Director and Producer, and Kailey Brackett, Lead Producer. 

Following the film, Cristie Upshaw Travis, MBGH CEO, moderated a first-of-its-kind panel discussion and Q&A session with representatives from Memphis’ four major hospital systems to address preventable medical mistakes and how their systems can work together to reduce error and improve care throughout the Mid-South. Participants (L-R) in the panel were:

  • Reginald Coopwood – Chief Executive Officer, Regional One Health
  • Jennifer Chiusano - Chief Nursing Officer, Saint Francis Hospital Memphis 
  • Michael Ugwueke – Chief Executive Officer, Methodist Le Bonheur Healthcare
  • Cristie Upshaw Travis - Chief Executive Officer, Memphis Business Group on Health
  • Henry Sullivant – Vice President and Chief Medical Officer, Baptist Memorial Health Care Corporation

Here are some highlights from the discussion:

Although patient safety is a national issue, it’s especially prevalent in Memphis. According to the spring 2018 Leapfrog Hospital Safety Grades, just 20 percent of hospitals earned an A or B. This compares to 94 percent in Nashville, 81 percent in St. Louis, 62 percent in Birmingham, Alabama, and 50 percent in Jackson, Mississippi. 

Baptist Memorial Health Care Corporation's Blue Brain project asks staff to "show their thinking"  so they can be properly trained to approach complex work and situations appropriately. Baptist has reduced bedside blood culture contamination by 50 percent through this method.

Methodist Le Bonheur Healthcare requires all associates and medical staff to complete patient safety training in order to practice in their facilities or be scheduled for work.

Regional One Health focuses on the actual numbers of medical errors, not the error rates. Focusing on the numbers keeps the patient impact front-and-center -- each number is a patient that experienced harm.

Saint Francis Hospital Memphis senior leaders audit specific key processes, such as surgical safety measures, in real-time, to monitor compliance and identify opportunities for improvement. 

At the end of the discussion, it was suggested that the health systems identify a patient safety action they could all take together, at the same time, to have a significant improvement across the entire community. The health systems all going tobacco free campus on the same day increased the visibility of the harms from tobacco use; showed the health system leadership on a critical health issue; and provided a community standard for what it meant to work in healthcare in Memphis. A similar approach can be considered for patient safety.

Interested learning more? Contact Cristie at [email protected]

Posted by Cristie Travis at Tuesday, June 5, 2018

Trump's "American Patients First" Blueprint To Reduce Drug Costs: The Employer Perspective

On May 11, the Trump Administration released "American Patients First," the President's blueprint to lower drug prices and reduce out-of-pocket costs for consumers. The document identifies four challenges: 1) high list of prices for prescription drugs, 2) lack of price negotiation tools in federal health programs, 3) high and rising out-of-pocket costs for consumers and 4) US footing the bill for lack of foreign countries' investment in research and development. 

The plan identifies four key strategies for reform in two phases, including actions the President may direct HHS to take immediately, and actions HHS is considering, on which feedback is being solicited. The four strategies are: 1) increased competition, 2) better negotiation, 3) incentives for lowering list prices, and 4) lowering out-of-pocket costs.

Click here to read the full Health Policy in Transit brief, focused on the employer's perspective.

Posted by Cristie Travis at Tuesday, June 5, 2018

MBGH Announces May 2, 2018 Lightning Round Contestants

Note our new time!

Wednesday, May 2, 2018
Rhodes College
Bryan Campus Life Center
McCallum Ballroom, second floor
8:30 am - 11:30 am

A hot breakfast will be served!

Join us as we recognize our CEO Culture of Health participants that met program requirements in 2017 and area hospital(s) for their performance in quality and safety. 

In addition to our recognitions you will participate in "Lightning Rounds" where three of our Annual Supporters will give you 15-minute "lightning-fast" presentations! Moving around the room from presentation to presentation in small groups will keep you active, engaged, and provide you a networking opportunity. And you will leave the meeting with ideas about how to better engage your employees and refresh your health and wellness programs.

This year we will be taking pictures of teams and their award during the Lightning Rounds as well as recognizing you during the awards part of the meeting.

MBGH Members, Annual Supporters, and CEO Culture of Health participants are all invited!

Thank you to our sponsors: BlueCross BlueShield of Tennessee and Cigna!

Click here to register.

Our Lightning Round contestants are:

Adventia Wellness's patent-pending software identifies early on individuals at hidden and rising risk for heart attacks, strokes and diabetes. Adventia applies the latest science not typically used by physicians or in corporate-sponsored wellness programs and draws on lessons from behavioral health, which helps drive engagement and sustain change.  A four-year corporate wellness program with Varsity Spirit in Memphis helped participants lose weight and waist circumference, reduce bad cholesterol and triglycerides without medications, and returned diabetic and pre-diabetic glucose levels to normal. Adventia Wellness has been offered through providers and programs in four states.


LifeSpeak is being presented by MBGH Annual Supporter Connect Healthcare Collaboration. LifeSpeak delivers the world’s leading experts directly to employees through an easy to use digital well-being platform. The short, expert-led videos and podcasts, give employees easy access to over 1,800 custom produced sessions and tip sheets. Topics include preventive health, mental health, physical conditions (such as diabetes), marital relationships, parenting, financial well-being, and more!


WellDoc's BlueStar diabetes management platform is an FDA-cleared diabetes personal assistant for your employees. with type 2 diabetes. BlueStar provides personalized, real-time feedback that improves self-management. Features include patient-to-provider connection, in-app education adapted from the American Association of Diabetes Educators, and 24/7 tailored self-management support. BlueStar provides significant A1c reduction on average of 1.7 to 2.0 points, based on clinical outcome data from randomized trials and real-world programs.

Posted by Cristie Travis at Thursday, April 5, 2018

Patients Overpay for Prescriptions 23% of the Time

A new study released by the University of Southern California found that the 1.9 million people that filled 9.5 million prescriptions in the first 6 months of 2013 overpaid for those prescriptions 23% of the time for a total of $135 million in overpayments.

Turns out, their copay was higher than the full cost of the drug. Referred to as a "clawback", the middlemen that handle drug claims essentially "claw back" the difference between the higher copay and the lower cost of the drug from the retail drug store. 

Although the amount per prescription that is clawed-back is often small, the frequency with which this happens results in significant overpayments. Clawbacks on generic drugs averaged $7.32 and were $13.46 on brand-name drugs.

Patients aren't often told they could pay less if they don't use their insurance.

Some insurance companies actually prohibit pharmacists from telling paitents. On March 14, bi-partisan federal legislation was introduced to ban "gag clauses" prohibiting pharmacists from informing patients they could save money if they paid in cash. Several states have already passed legislation to rein in clawbacks and prohibit gag clauses.

There has been increased legal activity around clawbacks and gag clauses in recent years with cases against UnitedHealth, Cigna, Humana, and OptumRX. This month, a federal judge allowed a proposed class action law suit against Cigna to proceed.

Employers should review their health plan and PBM contracts to determine how these types of overpayments are handled. Gregory I. Madsen of Innovative Rx Strategies recommends that employers include "the lowest of" language to ensure that their employees pay the lowest of the discounted ingredient cost, the pharmacy's usual & customary, or the co-pay, and not just automatically the co-pay.

Information for this article was provided by Bloomberg NewsCFO Daily News, and Kaiser Health News.

Posted by Cristie Travis at Tuesday, March 27, 2018

Unpacking Spending Growth

On March 13, 2018, the pronouncement was made that in 2016 price, once again, was the major reason the U.S. spends twice as much on health care as other developed countries (JAMA.2018;319(10):1024-1039). 

At the end of their article the authors frame this a health policy issue: “As patients, physicians, policy makers, and legislators debate the future of the health care system, data such as these are needed to inform policy decisions.”

Categorizing U.S. health care prices as a health policy issue seems somehow to let the rest of us off the hook. But how can we leave it up to policy makers when the prices employers and employees are paying today are the real underlying cause of their increasing spend?

Perhaps there has not been enough private sector action on price because the significance of the issue has not been recognized. A new report from Memphis Business Group on Health lays out the case that price deserves increasing employer attention. 

The complete report, based on analyses conducted by the Health Care Cost Institute (HCCI) ( and published in HCCI's 2016 Health Care Cost and Utilization Report (January 2018) and Issue Brief #13 (August 2017), is available to MBGH employer Members and Annual Supporters. The report includes MBGH-prepared charts, graphs, and analysis focused on the points of interest to employers, including upper-level management, that make the case for focus on price.

Highlights from the report include:

  • Total U.S. health care spending increased 4.6% from 2015 to 2016, the highest increase in the last four years
  • Nationally, utilization actually declined from 2012 to 2016 for inpatient (-12.9%), outpatient (-0.5%, although there was an approximately -5% from 2012-2014), and professional service (-2.9%) categories. Prescription drugs was the only category to experience a slight increase (1.8%)
  • During this same time period, cumulative price increases occurred across all categories ranging from a low of approximately 15% for professional services to a high of approximately 25% for prescription drugs. 
  • Declining utilization along with significant increases in prices resulted in total spending increasing 15% from 2012 to 2016.
  • In Memphis, prices were consistently below national averages in inpatient, outpatient, and physician services for the period 2012-2014.
  • With the exception of inpatient services, Memphis prices closely mirrored national increases from 2012 to 2014.
  • Memphis prices were in the middle of the pack with Nashville being a higher priced market and Knoxville being a lower priced market.

Please refer to the publications on for detailed descriptions of data sources, methods, and limitations of this information.

It is not surprising that as utilization has declined (almost across the board), price has increased. If the health care system wants to maximize revenue while experiencing declining utilziation, the only reaction is for them to increase prices. Since employers and their employees and families are paying for these price increases, they are the ones bearing this burden; often to the detriment of their own business and personal financial status.

Although prices in Memphis were consistently below the U.S. average (2012-2014), we know that the U.S. average is too high and is increasing significantly across all categories and local rates are increasing similarly (except for inpatient). Memphis may be fairing better than many markets but we should not take comfort that our high prices are lower than high prices in other markets.

The impact of price on spend means that employers need to change their purchasing approach, moving away from the traditional focus on discounts, to more targeted purchaser strategies that unpack the growth spend and address the underyling factors of price, utilization, and quality/safety. The MBGH report suggests strategies employers should deploy, such as analyzing their own data to identify price and utilization trends; pegging payments to Medicare prices; setting fair prices in new payment models;  and selecting netowrks with high quality/safety performance.

If you work for an MBGH Member employer or Annual Supporter and have not yet received your copy of the complete report, please email [email protected] for a copy.


Posted by Cristie Travis at Sunday, March 25, 2018

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