The Memphis Business Group on Health (MBGH) is pleased to make this forum, including all web pages and web sites accessed from this page, available to Web Site users and others. However, the MBGH does not render legal or consultation services, and legal counsel must be consulted to determine any material’s applicability to any specific situation. MBGH cannot warrant or control the quality, accuracy, or validity of the information posted here. Comments posted on this blog are the sole responsibility of their writers. Use of such information is at the risk of the accessing user and the accessing user assumes all liabilities that may result from such use.




Page 2 of 8

MBGH Hospital Safety Grade Facebook Ad Reaches 8,000 Memphians!

To reach more Memphis-area residents to help them learn about the Hospitals Safety Grade and see results for local hospitals, MBGH ran an ad on Facebook for a week last fall. Click here to read about Memphis hospital grades.

The results were impressive with 7,920 people reached and 696 engaging with the post by clicking on the map or going to the Hospital Safety Grade website for more information.

Although it makes sense, it was interesting to note that as people aged they were more likely to engage with the post with almost 50% (311) of those that engaged being age 55-64. This age group has a higher likelihood of being hospitalized than those under age 55.

And, in a similar finding, 91% (634) of those that engaged were female. We all know that women are the most engaged in their family's health.

Other findings include:

91% of post engagements were from smart phones

70% of the clicks to the website occurred Friday-Sunday

These findings help us define the key audience for the Hospital Safety Score and social media provides us a flexible, customizable platform to reach that audience.

You can use the results of this ad to help you plan how to best reach your employees with the Hospital Safety Grade information. You can also use similar analyses to better understand how employees are engaged with your other health and health benefit communications. Refresh your memory on the employee segmentation recommendations that Benz Consulting made at our 2016 Annual Conference here. Download the presentations and see the Benz presentation at page 142.

Posted by Cristie Travis at Tuesday, January 3, 2017

How NQF Matters in Memphis

From the desk of Cristie Upshaw Travis, CEO, Memphis Business Group on Health 

As announced in early December 2016, I am honored to have been elected to the Board of Directors of the National Quality Forum (NQF).

Do you know how much the work of NQF matters in Memphis? For example:

  • Today, over 300 NQF-endorsed measures are used in more than 20 federal programs. These measures and programs help determine the care that Memphis-area Medicare participants receive and how and how much our Memphis hospitals and physicians get paid by Medicare.
  • Regional health plans in Tennessee, such as BlueCross BlueShield of Tennessee and Cigna, tend to follow Medicare's lead in both coverage and payment approaches.
  • The measures used in the Hospital Safety Grade and Leapfrog Hospital Survey for Memphis-area hospitals are NQF-endorsed.
  • Tennessee health plans use NQF-endorsed measures to evaluate the quality of their networks and in their new payment models.

And, because of NQF, we can compare the quality and cost of care we have here in Memphis to other communities across the country since each community is using the same measures and data to evaluate care. Through the NQF we have standardized our measures so we can track our own improvements over time and identify best practices both within Memphis and elsewhere to rapidly advance care delivery.

Since 1997, MBGH has focused on working toward and advancing value-based purchasing in the greater-Memphis market. We defined value-based purchasing as a function of health status/outcomes, patient experience, and cost. Right away we were challenged with the fact that although employers knew their costs, but they had no idea what they were getting in terms of the health status/outcomes for their employees or the experience their employees were having as they navigated the healthcare delivery system.

We were not alone in lacking this information and understanding. The nation as a whole only had crude ways of evaluating the quality and experience of care using such measures as mortality, length of stay, and cost per stay/day in the hospital. Unfortunately, these early measures didn’t really help us understand the underlying issues that were driving these results, nor did they provide information upon which we could make purchasing decisions or help employees select providers.

Fast forward 20 years later to 2017 and we are now operating in a very different world. In fact, there are many who say we have too much information now! So, how do we decide what measures to use and when to use them?

The National Quality Forum (NQF) was established to help us answer these questions. Through it’s measure endorsement process, NQF:

Calls for measures that matter for health/well-being; prevention/treatment of leading causes of mortality; person and family-centered care; effective communication and care coordination; patient safety; and affordable care. 

Conducts detailed reviews of proposed measures through standing committees to ensure they reflect sound science, will be useful to providers and patients, and will make a difference in improving quality. 

Seeks public comment and input from any interested party during the decision-making process.

Provides oversight of committee decisions through the Consensus Standards Approval Committee which helps ensure consistency across standing committees and alignment with overall NQF goals.

Includes an appeals process through an Appeals Board.

I have always thought it was important to be actively involved in national policies that have such a significant impact on the Memphis community. After all, if we don’t get involved, we may find that the measures and the quality and cost that they drive are not in our best interest. I am often the only Southerner on a committee; I am often one of only a few employer/purchaser representatives on a committee; I am often one of only a few market-focused (vs. nationally or institutionally-focused) representatives on a committee. All of these voices need to be heard during the decision-making process. And, because I am involved, I have a much deeper understanding for these measures that are critical to the quality, cost, and payment right here in Memphis.

Please let me know if you have any questions about NQF. I am also available to speak with you and your senior leadership about NQF and the role it plays in measurement and federal programs. The more we understand and the more active we are, the better this process will be for us in Memphis.

Posted by Cristie Travis at Tuesday, January 3, 2017

MBGH CEO Elected to National Quality Forum Board of Directors

On December 3, 2016, The National Quality Forum (NQF) announced the appointment of Cristie Upshaw Travis, chief executive officer of the Memphis Business Group on Health, as well as two other new members to its Board of Directors:

  • Jonathan Perlin, MD, PhD, president of clinical services and chief medical officer of HCA; and
  • Jack Resneck, MD, professor and vice chair of dermatology at the University of California, San Francisco.

According to Travis, "I am honored to be selected to serve alongside national health, healthcare, consumer, purchaser, and policy leaders as the National Quality Forum continues our commitment to lead collaboration to improve health and healthcare through measurement and quality initiatives".

In addition to serving on the NQF Board of Directors, Travis co-chairs the NQF All Cause Admissions/Readmissions Standing Committee and its Measures Application Partnership Hospital Workgroup, which advises CMS on measures for use in federal programs. She also served as Vice Chair and Chair of NQF's Consensus Standards Approval Committee.

Composed of 21 members, the NQF Board provides organizational guidance on strategic and policy issues. Representatives include key public- and private-sector leaders who represent a wide range of major stakeholders in America’s healthcare system, including consumers and those who purchase healthcare on their behalf.

Other NQF Board members include:

  • Bruce Siegel, MD, MPH (Chair), America’s Essential Hospitals
  • James Chase, MHA (Vice Chair), Minnesota Community Measurement
  • Lawrence M. Becker (Treasurer), Xerox Corporation (retired)
  • Andrew B. Bindman, MD, Agency for Healthcare Research and Quality
    Designee: Nancy J. Wilson, MD, MPH
  • Carol Cronin, Informed Patient Institute
  • Leonardo Cuello, JD, National Health Law Program
  • Helen Darling, MA, National Quality Forum
  • Elizabeth Fowler, PhD, JD, Johnson & Johnson Health Care Systems, Inc.
  • Thomas R. Frieden, MD, MPH, Centers for Disease Control and Prevention
    Designee: Peter A. Briss, MD, MPH
  • William Kramer, Pacific Business Group on Health
  • James Macrae, MA, MPP, Health Resources & Services Administration
    Designee: Deborah Parham Hopson, PhD, RN
  • Carolyn Pare, Minnesota Health Action Group
  • Laurel Pickering, MPH, Northeast Business Group on Health
  • Louise Probst, St. Louis Area Business Health Coalition
  • Lewis Sandy, MD, UnitedHealth Group
  • David Shahian, MD, Massachusetts General Hospital Center for Quality and Safety
  • Andy Slavitt, Centers for Medicare & Medicaid Services
    Designee: Kate Goodrich, MD
  • Kirsten Sloan, American Cancer Society Cancer Action Network


Posted by Cristie Travis at Tuesday, January 3, 2017

Lots of Movement in Memphis Fall 2016 Hospital Safety Grades

We saw quite a bit of movement in the fall 2016 Hospital Safety Grades (formerly Hospital Safety Score) for Memphis-area hospitals:

Several hospitals raised their scores:

  • Baptist Collierville moved from a C to a B
  • Baptist Desoto moved from a C to a B
  • Methodist Germantown moved from a C to a B
  • Regional One Health moved from a D to a C

Unfortuantely, Saint Francis Memphis moved down from an A to a B and Methodist University moved down from a B to a C.

Methodist Olive Branch received it's first grade and it was an A. They join Saint Francis Bartlett as our Memphis-area A hospitals.

Methodist Olive Branch A

Saint Francis Bartlett     A

Baptist Collierville           B

Baptist DeSoto                B

Methodist Germantown   B

Saint Francis Memphis   B

Baptist Memphis           C

Methodist North             C

Methodist South             C

Methodist University       C

Regional One Health      C








Check out for details on these scores as well as those for 2,633 hospitals

Posted by Cristie Travis at Tuesday, January 3, 2017

How Might Health Reform Change Under President-Elect Trump?

If you are like me, you are now coming out from under the campaign and the election itself and beginning to think about the implications of the results for health reform and employer-sponsored health benefits.

Here are some articles that will help you begin to identify the key issues and strategies that are likely to emerge.

Obamacare Replacement Might Look Familiar, Kaiser Health News

Where President-Elect Donald J. Trump Stands on Six Healthcare Issues, Kaiser Family Foundation 

What Bipartisan Opportunities Will the Next Congress and President Have to Improve Health Policy, Health Affairs

Presidential Candidate Donald J. Trump's Health Proposal (as of September 2016), Commonwealth Fund

Posted by Cristie Travis at Thursday, November 10, 2016

MBGH Receives the National Alliance Member Leadership Award

WASHINGTON – Sept. 29, 2016 – The Memphis Business Group on Health received the Member Leadership Award at the National Alliance of Healthcare Purchaser Coalitions* (National Alliance) annual conference. The recipient was recognized for their efforts to improve the quality and efficiency of the healthcare delivery system and health of employees and communities.

(*Formerly the National Business Coalition on Health)

The Memphis Business Group on Health, under the leadership of CEO Cristie Upshaw Travis, has long played a critical role in encouraging and assisting Memphis-area employers to not only create a culture of health within their organizations, but to implement programs that will more broadly help the entire community. The coalition works with Tennessee hospitals, physicians, health plans, community and government leaders to drive healthcare delivery system reform.

MBGH sponsors the CEO Culture of Health initiative with 64 organizations in the Memphis-area currently participating and was a founding member of the Common Table Health Alliance (formerly Healthy Memphis Common Table) as well as Healthy Shelby. National efforts include Travis serving on the National Alliance board; as a board member and Regional Roll-out Leader for The Leapfrog Group, a hospital patient-safety organization; and co-chair of committees of the National Quality Forum, the multi-stakeholder, consensus-building organization that leads national collaboration to improve health and healthcare quality through measurement.

“Memphis Business Group on Health is a proud member of the National Alliance, learning from our sister coalitions and helping where we can to share our experience and expertise to assist purchasers nationally,” said Travis. “We are honored to be recognized for our 31 years of work to create, support and sustain a culture of health at the workplace for our members and their families.”

The National Alliance’s Member Leadership Award is sponsored by Merck.

About the National Alliance of Healthcare Purchaser Coalitions

The National Alliance is a nonprofit network of business health coalitions, representing more than 12,000 purchasers and 41 million Americans. Its members are dedicated to driving innovation, health and value through the collective action of public and private purchasers. The organization seeks to accelerate the nation’s progress toward safe, efficient, high-quality health care and the improved health status of the American population.

Posted by Cristie Travis at Thursday, October 6, 2016

See Why Cristie Thinks You Should Attend the August 18 Conference

Click here to learn more and register

Posted by Cristie Travis at Tuesday, July 12, 2016

MBGH 2016 Conference Update: More Breakout Sessions Announced

Click here to register for MBGH's August 18, 2016 Annual Conference "Rethink Employee Engagement to Drive Better Results". Early registration ends July 10 and prices increase July 11.

Three more breakout sessions will be offered at 10:45. Start thinking now about which one you will attend. They are all excellent and you can only attend one! 

ReThink: The Essential Role of Benefits Communication in Employee Engagement

Brandon Moore, Strategic Accounts Manager, Benz Communications

The evidence is clear that employees value their health benefits and these benefits contribute to employee recruitment, retention, and loyalty. In this session, learn how to develop and implement an employee communication strategy that reinforces the value of these benefits by communicating year-round; using multiple channels to reach employees; integrating data to identify key goals; and targeting messages to drive action.   

ReThink: Consumerism: Aligning Employees & Employers

Tom Parry, President, Integrated Benefits Institute

Many employers are moving to consumer directed health plans (CDHPs) to better manage costs of health benefit plans. However, decisions employees make in these plans impact not only health benefit costs, but also short-term and long-term disability and productivity. In this session, learn how to consider total cost; better understand how employees behave in CDHPs; and steps two employers have taken to maximize employee engagement and health improvements in their CDHPs.

ReThink: Health Care Providers are Engaging Patients Differently Too!

Representatives from Baptist Memorial Health Care, Methodist Healthcare, Regional One, Saint Francis Healthcare

For many of the same reasons employers are rethinking how they engage employees in their health and wellness programs, health care providers are also redesigning how they provide care and engage patients in their own health and health care. This session will highlight new delivery models being implemented by Baptist, Methodist, Regional One, and Saint Francis and the implications of these new approaches for your employee’s health and wellness and the effectiveness of your health benefit plans.

Learn about our Keynote Speakers here

Learn about our 9:30 Breakout Sessions here

Posted by Cristie Travis at Tuesday, July 5, 2016

MBGH 2016 Conference Update: First Three Breakout Sessions Announced!

Click here to register for our 2016 Wellness & Health Benefits Conference "Rethink Employee Engagement to Drive Better Results" on August 18, 2016!

You will get to attend one of the following 9:30 breakout sessions. Start thinking about it now because they are all excellent and it will be a tough choice!

ReThink: Full Engagement: Harnessing the Power of Participation

Barbara McClanahan, PhD, EdD, Associate Professor, University of Memphis Health Promotion Program

Employees are often the most powerful advantage an organization has. However, the expertise, talents, insights, and creativity brought by individuals is quickly lost if the employee is not fully engaged with the organization. This interactive, audience participation session highlights the importance of participatory management practices and offers specific strategies to enhance your employee engagement in health benefits and wellness programs.

ReThink: Putting the Power Where it Belongs: With Employees

Cameron Brackett, Executive Director, MidSouth eHealth Alliance

Dinesh Sheth, Founder & CEO, Green Circle Health

The health care delivery system, and many benefits programs, make it easy for employees to be passive participants because the “power” is vested in the providers and programs. Employees become reactive vs. proactive managers of their own health. This session explores how technology can put the employee in charge of their own health information to track it, improve it, and share it with whom they choose, moving them from passive participants to active managers of health.

ReThink: Personalized Support When Your Employees Need it Most

John Dyson, Director of Human Resources, Enterprise Health Care, FedEx Services

David Hines, CEO, Consumer Medical

One-size fits all benefit and wellness programs fail to recognize that employees have specific health needs at different times throughout their lives. Online decision-support and outbound care management and coaching are often designed to meet the broadest set of needs and, therefore, may not effectively engage employees. This session highlights the benefits of offering personalized support for your employees and the impact on costs, quality of care, and employee satisfaction. Federal Express will share why they decided to offer such a program and the difference it has made for their employees and their benefit program performance. 

Posted by Cristie Travis at Monday, June 13, 2016

Keynote Speakers Announced for MBGH 2016 Wellness & Health Benefit Conference

Click here to register now to come "Rethink Employee Engagement to Drive Better Results" and hear from these national experts on why you must rethink your approach and which strategies work to engage employees and reduce health benefit cost trend!

Shelly Wolff, Health and Workforce Effectiveness Leader and a senior consultant in Willis Towers Watson's New York City office, kicks off the conference addressing the very real disconnect between the health and wellness benefits employers offer and employee perspectives of these same benefits. As Shelly puts it, "While the hot-button issues of stress and obesity remain ever-present, the numerous programs and incentives designed to combat them have failed to effectively engage employees. Employers may find the key to making better progress hinges on looking at these programs through an employee’s eyes.” Shelly will shed light on how employees perceive these benefits and share suggested strategies to help you rethink how you select and implement programs to actually engage your employees.

Shelly, with Willis Towers Watson since 2003, provides thought leadership in global health and worker effectiveness and health and work performance research. including innovative engagement approaches that deliver optimal business value. Prior to joining Willis Towers Watson, she was Health and Productivity Leader for GE for 10 years.

Kim Stroud, Employee Benefits Manager for Manatee County, FL, our luncheon speaker, will share the story of how Manatee County has achieved a -2.3% health benefits trend since 2009. She will share the specific health benefit and wellness strategies they deployed that have resulted in employee engagement rates in the high 90%. Creative benefit designs, health plan and vendor collaborations, incentives, integrated clinical advocacy, and now an onsite clinic are just some of the pieces that have increased employee engagement and resulted in a negative trend. 

Kim has served as Employee Benefits Manager for the past 10 years and was previously the Director of Health and Lifestyle Management for almost six years. Her Masters in Human Development Counseling certainly prepared her to develop a comprehensive program built on engagement and the stages of change. She is a frequent national speaker on how Manatee County has achieved savings and improvements in health without cost shifting to employees.

Posted by Cristie Travis at Friday, May 27, 2016

5 Things Employers Would Change About the ACA

Given a magic wand, employers would make signficiant changes to the ACA. Here are the top 5 changes, according to John Barkett of Willis Towers Watson:

  1. Eliminate the Cadillac Tax
  2. Approve the Small Business Healthcare Relief Act
  3. Keep pushing health care delivery system reforms --- and enforcing anti-trust rules
  4. End the employer mandate
  5. Adopt provisions that better address the root causes of the high-cost of health care 

Read John's article in Employee Benefit Adviser here.


Posted by Cristie Travis at Friday, May 27, 2016

MBGH Among National Leaders Participating in CMS/AHIP Core Quality Measures Collaborative

The Centers for Medicare & Medicaid Services (CMS) and America’s Health Insurance Plans (AHIP), as part of a broad Core Quality Measures Collaborative of health care system participants, released seven sets of clinical quality measures on Tuesday, February 16, 2016 (

This first set of core measures, used as basis for quality-based payments, were developed by a new broad collaborative of health care system participants, including employers and consumers such as the Memphis Business Group on Health, Pacific Business Group on Health, National Partnership for Women and Families, AARP, and National Patient Advocate Foundation. The Collaborative also includes physician groups and professional organizations such as the American Academy of Family Physicians, American Academy of Orthopaedic Surgeons, American College of Cardiology, American Heart Association, American College of Physicians, American Gastroenterological Association, HIV Medicine Association, Infectious Diseases Society of America, American Academy of Pediatrics, American Society of Clinical Oncology, Council of Medical Specialty Societies, CAPG, and the American Medical Association. Regional collaboratives such as the Wisconsin Collaborative for Healthcare Quality and Minnesota Community Measurement, are also participants in the Collaborative and have provided their input and recommendations.

The guiding principles used by the Collaborative in developing the core measure sets are that they be meaningful to patients, consumers, and physicians, while reducing variability in measure selection, collection burden, and cost. 

The goal is to establish broadly agreed upon core measure sets that could be harmonized across both commercial and government payers.The core measures are in the following seven sets:

  • Accountable Care Organizations (ACOs), Patient Centered Medical Homes (PCMHs), and Primary Care
  • Cardiology
  • Gastroenterology
  • HIV and Hepatitis C
  • Medical Oncology
  • Obstetrics and Gynecology
  • Orthopedics

The Collaborative will continue to convene to monitor progress, invite broader participation, and add additional measures and measure sets.

Click here to see the selected measures.

Posted by Cristie Travis at Wednesday, February 17, 2016

Despite Delay in Excise Tax, Employers Continue to Explore Private Exchanges

From the National Business Coalition on Health: According to a survey of employers conducted by the Private Exchange Evaluation Collaborative (PEEC), 46% have implemented or are continuing to look at private health insurance exchanges to offer health benefits for their covered populations. 

Over the last few months PEEC has polled employers for a broad study on their views and intentions related to exchanges. A second shorter study was conducted in January to gauge strategies in light of the two-year delay in the implementation of the excise tax. 

Under the Affordable Care Act, employers whose health benefits cost more than $10,200 for individuals or $27,500 for families have to pay an excise or “Cadillac” tax of 40% on the amount above those figures. Prior to the extension of the excise tax implementation, employers were modeling whether their plans would hit the tax thresholds, and if so, when that would take place. Over 40% of employers expected to be exposed to the tax in 2018. 

"Overall, interest in private exchanges remains strong. This year’s results show interest is highest among small and mid-market employers, with 50% showing interest” says Barbara Gniewek, Principal at PricewaterhouseCoopers (PwC). “Interestingly, these employers are thought to have the most to gain from a private exchange, but noted a lack of available information and education on the solutions. 36% of employers over 10,000 have or are considering private exchanges.” 

Key findings 

  • When asked if they would consider using a private exchange for full-time active employees before 2019, 6% of employers responded they have contracted with an exchange, the same percent as in 2014 and somewhat fewer (40% versus 41%) indicated they are still considering this strategy. 
  • Over half of employers (53%) agreed that if an industry peer moved to a private exchange they would be more likely to do so. 
  • The rate of employers considering the public exchange for full-time active employees did not change year over year (16% in 2014 and 2015). 
  • Key attributes considered when evaluating private exchanges have remained stable from 2014 to 2015, with high priority placed on cost of moving to an exchange, customer experience, and networks available from the exchange plans. 
  • Almost half of early adopters of exchanges said they were able to save money. 
  • Company size is a determining factor in whether or not a company will consider a private exchange, with greater interest from small and mid-sized firms than larger ones. 
  • While over 60% of employers anticipate the excise tax will be repealed, employers continue to aggressively look at ways to reduce their exposure to the tax law. 

An executive summary of the findings along with additional details can be accessed here

 “Employers are more invested than ever in the value of their health care dollar,” said Larry Boress, president and CEO of the Midwest Business Group on Health. “Motivated by high medical care costs and their potential exposure to the ACA's excise tax, interest remains high among health care purchasers in exploring the potential value of private exchanges and other strategies to reduce their exposure to the tax. Many are focused on improving employee engagement through a suite of tools and services that will ultimately enhance the health of their population.” 

 Survey details 

These results come from two online surveys of employers’ views on health insurance exchanges conducted in November 2015 and January 2016. More than 350 employers (28% had less than 500 employees, 21% had 500 – 2,499 employees, 23% had 2,500 – 9,999 employees, and 28% had over 10,000 employees) from 34 different industries across the nation participated in the November survey. PEEC also surveyed 129 employers in January 2016 after the delay in the excise tax implementation was announced, to understand how this delay may have changed their views or intentions related to private exchange and other benefit and worksite activities. 

About the Private Exchange Evaluation Collaborative (PEEC)

The Private Exchange Evaluation Collaborative (PEEC) is an initiative launched in 2013 by four leading nonprofit business coalitions, Employers Health Coalition, Inc. (Ohio), Midwest Business Group on Health, Northeast Business Group on Health, and the Pacific Business Group on Health – all independent coalitions representing employer health care interests –and PricewaterhouseCoopers (PwC) (not an exchange provider). PEEC will solicit and provide unbiased, comparative information and support on private exchange strategies and purchasing decisions.

Posted by Cristie Travis at Wednesday, February 17, 2016

Is There a Link Between Worker Health, Stock Price?

According to three new peer-reviewed studies released in the Journal of Occupational and Environmental Health, there is growing evidence that the health and well-being of an organization is one component of a high-performing, well-managed organization.

An article in Employee Benefit News notes that  "The studies examined the change in stock prices for three portfolios of employers after they won awards for their employee wellness programs or self-scored themselves as having a comprehensive program. In all three cases, award winners and those with high scores outperformed the S&P index, at rates ranging from seven percent to 16% per year."

You can read the complete article here.

MBGH's CEO Culture of Health program, in support of Healthy Shelby, provides employers the framework to build a strong foundation of health and well-being and can contribute to meeting this component of a high-performing organization. Email Cristie Upshaw Travis if you are interested in learning more about this program, which includes technical assistance to help you with easy-to-implement strategies and get you off to the right start.

Posted by Cristie Travis at Tuesday, February 9, 2016

Learn What Works for Worksite Wellness Programs in Memphis

A special learning and networking session only for MBGH members and participants in our CEO Culture of Health program on April 26, 2016.

MBGH knows that you want to learn from each other what works in worksite wellness programs and how you made it work. 

Knowing what works right here in Memphis and Shelby County will give you confidence to consider similar programs and you will have someone you can contact to get more information, advice, and to share back your experience.

MBGH invites all of our members (and 2016 Annual Conference sponsors at the Supporter level and above) as well as participants in our CEO Culture of Health program to:

(1) Plan to attend our networking and learning session on April 26, 2016 at 10:00 at Rhodes College. Registration will be open soon. In this session, sponsored by BlueCross BlueShield of Tennessee, we will highlight examples of successful programs  in the greater-Memphis area and have plenty of time for sharing and discussion. Plan to stay for our 2016 Annual Awards Luncheon immediately after the session at Rhodes(11:15-1:30). We will be recognizing all CEO Culture of Health participants that met our requirements in 2015. Registration is complimentary to both events.

(2) Submit an example of a successful program or event you have implemented. We will compile the examples and give them to you. If no one shares their programs, there is no way to learn from others, so please submit! No program or event is too small. We all need new ideas for effective programming. Click here to download additional information. Deadline for submission is February 29, 2016.

Posted by Cristie Travis at Tuesday, January 19, 2016

Employers Get Ready for "It's Quittin' Time in Tennessee"

February 22-26 is "It's Quittin' Time in Tennessee" week, a statewide campaign to promote awareness of and resources for quitting smoking. Click here to download the graphic and use it in your communications to show your employees this is a community-wide campaign!

The evidence is clear why employers should care:

  • Quitting smoking saves lives, improves health and reduces health care costs.
  • Reducing workforce smoking rates improves employee health, increases productivity and saves dollars.
  • Reducing tobacco use rates promotes healthy communities from which you pull your employees.
  • There are resources available to help: Tennessee Quitline, local quit programs and health provider interventions

Frame this week as a kickoff to a campaign around tobacco cessation and plan to celebrate those that quit at the Great American Smokeout in November!

Here are some easy to implement suggestions, and resources, but be creative! We will post more specific "It's Quittin' Time In Tennessee" material as we get closer.

Be sure your employees know the benefits you offer them! This is a great week to highlight all the insurance benefits and tobacco and smoking programs you offer.

Consider a daily employee communication that week. You may want to take a page each day from 10 Things You Should Know About Quitting Smoking or Plan to Quit Cards 

Offer, or announce upcoming, smoking cessation classes. Did you know the Shelby County Health Department offers the highly successful and evidence-based American Lung Association's Freedom from Smoking classes free? (Note: this link is for Colorado but does an excellent job outlining the program and it's success)  Contact Courtney Tipper at (901) 222-9274 or for more information.

Here are some general resources you will find helpful:

Posted by Cristie Travis at Tuesday, January 19, 2016

New Hospital Safety Scores Released for Memphis Hospitals

The latest Hospital Safety Scores for Memphis-area hospitals are out! 

Results of interest include:  

  • The Regional One Health Center continued on it's improvement path with its grade moving up to a C.
  • The Methodist hospitals realized downgrades in their scores. Methodist University moved down to a B. Methodist Germantown, North and South moved down to a C. 
  • Congratulations to Saint Francis-Memphis for achieving Straight A's in all of the releases of the Hospital Safety Score since 2012.

The rest of the scores remained the same as in Spring 2015. 

Saint Francis - Memphis   A   Methodist - University    B   Baptist - Collierville            C
Saint Francis - Bartlett      A     Baptist- DeSoto                 C
     Baptist - Memphis             C
     Methodist - Germantown  C
     Methodist - North              C
     Methodist - South             C
     Regional One Health        C

Check out the full scores for these hospitals, as well as 2,520 other hospitals across the country, at You can also see the past scores for these hospitals by selecting "Show Past Grades".

Posted by Cristie Travis at Thursday, October 29, 2015

C-Sections Too Common in Memphis

Methodist-Olive Branch and Saint Francis-Bartlett are the only Memphis-area hospitals to fully meet the Leapfrog Group's C-section standard of no more than 23.9% of births. Other reported rates for Memphis-area hospitals ranged from 27.0% at the Regional Medical Center to 37.5% at Methodist-Germantown.

 HospitalC-Section Rate 
Methodist-Olive Branch
Saint Francis-Bartlett
Regional Medical Center
Saint Francis-Memphis

Baptist Memorial Hospital for Women and Baptist-DeSoto did not report C-section rates due to a mid-year change in data collection systems which resulted in 12-months of data not being available.

Tennessee ranked 24th in the nation with an average C-section rate of 28.3%.

Using C-section data reported by 1,122 hospitals through the voluntary 2015 Leapfrog Hospital Survey, Leapfrog found that, nationally, over 60% of reporting hospitals had excessive rates of C-sections. 

These results mean that far too many women in Memphis, Tennessee, and the U.S. are undergoing a major abdominal surgery without medical necessity.

Cesarean sections carry serious risks of infection or blood clots, and many women experience longer recoveries and difficulty with future pregnancies. C-sections can also cause problems for babies, like breathing difficulties that need treatment in a newborn intensive care unit (NICU). In the long-term, research shows that C-sections can cause chronic pelvic pain in some women, and babies born by C-section are at increased risk of developing chronic childhood diseases like asthma and diabetes.

“This is really about how well we, as doctors, nurses, midwives, and hospitals, support labor,” said Elliott Main, M.D., chair of Leapfrog’s Maternity Care Expert Panel and medical director of Stanford’s California Maternal Quality Care Collaborative. “Hospital staff that support labor appropriately and are sensitive to families’ birth plans are shown to have lower C-section rates overall. If we want to improve this rate across the board, then hospitals must hold themselves to this standard to ensure safe short- and long-term outcomes for both mom and baby.”

Click here to:

  • Read more about the methodology used to determine C-section rates
  • Provide your employees with information to help them avoid C-sections except when medically needed
  • Learn more about how providers and policy makers can help reduce unnecessary C-sections
Posted by Cristie Travis at Monday, October 12, 2015

New York Times Editorial Calls for Reduced Cost of Hep C Drugs

This New York Times (NYT) editorial lays out the tension in the current debate over the very expensive (@$84,000/treatment un-discounted) Hepatitis C drugs: broad coverage that will significantly increase health plan costs or restricted coverage to keep costs under control but that will not benefit as many patients.

In the end, the NYT points out that manufacturers generally pay what the market will bear so calls for public and private insurers to push for lower pricing, which can support providing these drugs to more people.

MBGH is kicking off a specialty pharmacy management initiative for members which addresses this very issue. The initiative provides hands-on training, data analysis and, most importantly, technical assistance and consulting, that employers need to actually achieve cost savings in specialty spend while still making these drugs accessible to their employees and families. Contact Cristie Travis at for more information.

Read the editorial

Posted by Cristie Travis at Thursday, September 3, 2015

First: Doctor Visits on Demand; Now: Medications Delivered to Your Doorstep

Health care innovators in New York City prove, once again, that where there is a need, entrepreneurs will step in to fill it.

This time Pager, a doctor-on-demand company, is teaming up with Zipdrug to have prescriptions delivered to a patient's home or office, often within one hour.

Customers can track the Zipdrug delivery status on their cell phones and pay the cost of the drug plus a $10 delivery fee.

Pager sends Board-certified physicians to homes and offices within 2 hours of a patient's request for urgent care needs. Currently they offer services in New York City and San Francisco. Read more about Pager.

Read the full article

Posted by Cristie Travis at Thursday, September 3, 2015

More Potential Twists on the Cadillac Tax

Ricardo Alonso-Zaldivar's September 1, 2015 AP post details the Treasury Department's current thinking about the Cadillac Tax: 

"— The Treasury Department says it is considering an exemption for flexible spending account contributions for dental and vision care, which are two popular uses.The health care law already limited FSA contributions and without such accommodations, the Cadillac tax could lead to their demise.

"A benefit that you are offering your employees so they can save money on taxes is going to wind up costing you money," said economist Paul Fronstin of nonprofit Employee Benefit Research Institute.

— Treasury is also trying to figure what do about a different kind of workplace arrangement called a "health savings account."

A growing number of workers have high-deductible health insurance that comes with tax-sheltered health savings accounts, or HSAs, that they and their employer can contribute to. But if an employee has his or her contribution deducted from their paycheck, it could potentially trigger the tax.

Officials say they're considering options."

The article also provides perspectives on the potential demise of Flexible Spending Accounts (FSAs). See related blog post here.

Read the full article here.

Posted by Cristie Travis at Thursday, September 3, 2015

Uninsured Rate Decreases to 9.2% in First Quarter 2015

According to a Dan Mangan September 1, 2015 blog post for CNBC:

"In the first three months of 2015, the CDC said, the rate of people without health insurance stood at 9.2 percent. That's down from 11.5 percent in the same period in 2014, and represents a 20 percent reduction in the uninsured rate over the past year.In absolute numbers, 29 million people lacked health insurance in early 2015, compared with 36 million people in 2014. That number reached a high 48.6 million in 2010, the year the ACA was signed into law by President Barack Obama."

"The CDC's report is the latest survey that strongly suggests the ACA is behind a marked decrease in the uninsured rate in the U.S., as well as declines in the number of people who have difficulty accessing and paying for care."

Read more about how this decrease occurred

Posted by Cristie Travis at Thursday, September 3, 2015

Fewer People Skipping Medical Care for Cost Reasons

According to the September 1, 2015 Amy Goldstein article in the Washington Post:

"During the first three months of the year, just 1 in 20 Americans said they did not get medical care they needed because they could not afford it, according to the U.S. Centers for Disease Control and Prevention.The findings, from the federal National Health Interview Survey, show that 4.4 percent of people interviewed from January through March said they had skipped medical care in the previous year because of its cost -- the lowest percentage in 16 years. The percent skipping care for cost reasons had reached nearly 7 percent in 2009 and 2010 and has been shrinking since then.

The survey, conducted with people of all ages, does not explain the reason why fewer people are avoiding treatment because of its cost, but the improvement coincides with two big changes: Health insurance has become more common under the Affordable Care Act as government exchanges began nearly two years ago to sell private insurance policies for people who cannot get coverage through a job and as Medicaid for low-income people expanded in some states. At the same time, the economy has been recovering from the Great Recession of 2008-09, so more people are working.The new CDC estimates provide the latest evidence of a significant lessening of  the ranks of Americans who are uninsured: 29 million Americans said they lacked health insurance coverage, 7 million fewer than in 2014."

Read the full article here.

Posted by Cristie Travis at Thursday, September 3, 2015

Isn't It Time That The Impact on Patients Be the Major Concern?

When exactly did we cross the threshold where we became more concerned about the financial impact on hospitals and doctors than on the health, and sometimes, actual lives of patients?

Why do commentaries, such as this one, which call out the shame of not righting this wrong in New York state, still include an argument that expanding laws allowing malpractice claims are likely to only result in a minimal increase in actual claims?

To give the author's credit, they make many of the right points:

  • Hospitals and doctors are doing a poor job of policing themselves, so malpractice laws that support patients are needed
  • Hospitals should do a better job of focusing on patient safety
  • Patients should not be limited to what they can collect 
  • Don't make it more difficult for patients to even get their case heard
  • Hold top hospital administrators accountable for negligence in their facilities
  • And, their final statement, " But as long as hospitals and doctors block legislation and fight regulation, patients will remain in peril."

I just feel that they should have left the financial discussion out because, by putting it in, they unintentionally support the flawed argument of the hospital and physician lobby that blocked "Laven's Law" from passing in New York. This is a moral issue, not a financial one.

Cristie Upshaw Travis, CEO, Memphis Business Group on Health

Posted by Cristie Travis at Monday, August 31, 2015

Narrow Networks Can Result in "Surprise" Bills for Patients and Employers

We've all heard the stories, or even experienced it ourselves, about finding out after-the-fact that the anesthesiologist used during surgery was out-of-network and, therefore, the patient and employer owe a lot more for those services that expected. This happens even though the hospital is in-network.

This situation is becoming even more frequent due to the expanded number of narrow-networks put in place with the advent of the Marketplace (aka public health insurance exchange) and in the growing number of employers offering narrow networks as a cost-reduction strategy.

And anesthesiology isn't the only specialty where this can happen. Emergency room physicians, pathologists, radiologists, specialists, and hospitalists are just examples of other, hospital-contracted physicians, that may not be in-network.

Although many insurance companies and self-insured employers have taken steps to protect the patient from the balance billing, the higher out-of-network costs (then picked up by the insurance company or employer) still accrue and add to the increasing high cost of care and therefore premiums.

For employers: What do you do to protect yourself, as well as your employees and their families, from this type of balance billing? How do you hold your health plan or hospitals accountable for having contracted physicians in the networks they accept?

Read more.

Posted by Cristie Travis at Monday, August 31, 2015

New, Very Expensive Treatments for Cholesterol Approved

NOTE: MBGH's new, specialty pharmacy management program for members is exactly what employers need to make the tough decisions around how to manage the costs of the new, very expensive treatments for high cholesterol, while still getting this treatment to those that need it. Contact Cristie at to learn more.

Two drugs in a new class of cholesterol-lowering treatments have now been approved by the FDA --  Praluent, made by Sanofi Regeneron and approved last month, which costs $14,600 a year, and Repatha, made by Amgen and approved last Thursday, at $14,100 a year. Typically, patients that can't tolerate statins, the most prescribed drug class for the treatment of high cholesterol at a cost of only pennies per day, are candidates for the new drugs. Like statins, the new drugs are taken for the rest of a patient's life, resulting in well over 6 figure cost of treatment.

Read this article in the New York Times to get an understanding for the dilemma patients, physicians, insurance companies, and self-insured employers are facing regarding use of these new drugs.

Posted by Cristie Travis at Monday, August 31, 2015

Flexible Spending Accounts May Disappear

Richard Stover, an actuary with Buck Consultants, predicts that Flexible Spending Accounts (FSA) will be the first to go if the Cadillac Tax moves forward as planned.

FSAs allow employees to save their own money, pre-tax, to pay for various health-related expenses including co-pays and deductible, eye glasses, and more. According to Stover, eliminating FSAs may be the most obvious way the Cadillac Tax impacts the middle class.

The Cadillac Tax, which taxes the amount of benefits over $10,200 for individuals and $27,500 for families beginning in 2018, is expected to apply to traditional health insurance, supplemental health insurance plans, flexible spending accounts and, potentially, worksite clinics. 

In his August 31, 2015 article in Politico. author Brian Failer points out that "The Cadillac tax will cap for the first time the open-ended tax break employers receive for providing their workers with health benefits. Economists love the tax because they say that break is a big reason for rising health care costs. Overly generous insurance coverage shields beneficiaries from having to worry about the cost of their care, they say, which encourages them to use more services, which drives up prices.But the tax is quickly becoming one of Obamacare’s least popular components, and businesses and unions alike are demanding lawmakers scrap it before it takes effect."

Repeal of the Cadillac Tax is being pushed for from many fronts, but is not expected to happen during the Obama administration. Both Clinton and Sanders have signaled willingness to reconsider it if elected.

In the meantime, employers are already taking steps to avoid the tax and it is doubtful that they will reinstate many of these changes if the tax is repealed.

Read more here.

Posted by Cristie Travis at Monday, August 31, 2015

Memphis Restaurants Receive Eat REAL Tennessee Recognition

Through a partnership between the Tennessee Department of Health and the United States Healthful Food Council (USHFC), Eat REAL™ Tennessee has announced the first REAL Certified establishments in Memphis.

Responsible Epicurean and Agricultural Leadership (REAL) is a growing national program that helps combat diet-related disease by recognizing foodservice operators committed to holistic nutrition and environmental stewardship. 

MBGH encourages all employers to share this list of restaurants with your employees and their families so they can eat healthy outside of work too! Click here to see the list and learn more about the restaurants and share the link with your colleagues.

Memphis’s inaugural class of REAL Certified foodservice establishments can be found throughout the city and include: 

Andrew Michael Italian Kitchen     
Cafe Eclectic
City Market 
The Farmer
Fuel Cafe
Hog & Hominy
Lettuce Eat Salad Co.
Taziki’s Mediterranean Cafe     
Trolley Stop Market
Two Vegan Sistas

“Memphis is a city rich in local food culture and community, and these eating establishments are helping shift the environment towards a more healthful and sustainable model,” said Eat REAL Tennessee Project Manager Nikkole Turner.   

Eat REAL Tennessee is a statewide initiative supported through a grant from the Tennessee Health Department as part of an innovative approach to preventing diabetes and obesity across the state. The program also serves as a community outreach platform, engaging and educating the public on nutrition and healthy dietary choices.   

Utilizing the points-based REAL Index, independent registered dietitians conduct an assessment of menu offerings and overall nutrition and sustainability practices. Establishments are credited with points across a range of criteria such as the use of vegetables, fruits, whole grains, healthy preparation methods, moderate portion sizes, unsweetened beverages, healthy children’s options and sustainable sourcing. Those that satisfy the necessary requirements are awarded and recognized as REAL Certified.    

The USHFC has partnered with the Memphis Business Group on Health (MBGH) and certified its annual awards luncheon this year at Rhodes College. “We were able to offer our awardees a healthy and locally sourced meal in support of our mission and that of the USHFC’s,” said Cristie Travis, Chief Executive Officer of the MBGH.    

All REAL Certified establishments are featured on and promoted through the USHFC’s local partners to help identify “better for you” dining options. The USHFC is partnering with FITKids, a program of the University of Memphis, to help Memphians find healthy family friendly dining establishments through its website and mobile app.   “Shelby County Government is very excited to be working with Eat REAL Tennessee to provide healthier options to our employees and encourage better nutritional choices,” said Shelby County Deputy Administrator Brenda Greene.   

The newly certified Memphis establishments mark an expansion of REAL Certified, which launched with a restaurant campaign in Washington, DC, two years ago and has since grown to include restaurants, workplace dining facilities and public venues in 28 states.    

ABOUT THE UNITED STATES HEALTHFUL FOOD COUNCIL (USHFC) Established in 2011, the USHFC is a 501(c)(3) registered nonprofit, dedicated to fighting diet-related disease by realigning the food industry’s incentives with consumers’ health interests. The USHFC works towards its mission through the REAL Certified holistic nutrition and sustainability certification program. REAL Certified foodservice operators must satisfy prerequisites and earn sufficient points in the areas of Responsible (nutrition), Epicurean (preparation), Agricultural (sourcing) and Leadership (going above and beyond). More information can be found at and 

Posted by Cristie Travis at Monday, June 22, 2015

Telemedicine Expansion Gets Boost from Walgreens, United, Anthem

According to Modern Healthcare, Walgreens plans to reach about half the country with computer based telemedicine programs (also adapted for tablet, smart phones) by December 31, 2015. This announcement falls on the heals of plans announced by Anthem and United to expand their telemedicine services to more than 40 million by next year.

The American Telemedicine Association estimates that 450,000 Americans had telemedicine visits last year for primary care and although that number is only a small portion of the total 15 million people that access telemedicine, it has doubled in the past two years.

Read the Modern Healthcare article here.

The potential impact on health care costs is clear when you realize that the average cost of a telemedicine visit is $39 compared to a physician visit at $120 and ER visit of $499.

Posted by Cristie Travis at Friday, June 19, 2015

Health Care Cost Increases Picking Up Speed

Drew Altman, in his June 11, 2015 WSJ blog post, believes the "lowest of the lows of the health cost slowdown are now in the rear view mirror" and as the economy has recovered, people are using more health care services. In addition, more people covered through health reform are likely impacting the increase as well. Read the blog post here.

Posted by Cristie Travis at Friday, June 19, 2015

Out-of-Network Charges Can Break the Bank

A recent report from America's Health Insurance Plans (AHIP) shows that across the US, some physicians are charging patients fees that are 10 times, and in some cases as much as 100 times, the amount Medicare pays when patients go outside their health plan's network. In Tennessee, for the selected procedures, out-of-network charges range from 7 times what Medicare pays to 33 times what Medicare pays.

Hospitals have adopted a similar strategy. A study reported in the June edition of Health Affairs found that the 50 hospitals with highest prices charged, on average, 10 times the Medicare allowed amount. A CMS study released June 1 found a similar pattern with hospitals charging, on average, $54,000 for a major joint replacement compared to Medicare's average payment of less than $15,000. Read the NY Times article here.

There is increasing pressure on health care providers from both the public and private sectors to re-examine these policies and to get charges more in line with Medicare payments.

Posted by Cristie Travis at Friday, June 19, 2015

CVS Almost Doubles in Memphis Through Purchase of Target Pharmacies

CVS's purchase of Target pharmacies will almost double the number of CVS locations in the Memphis-metro area, making CVS a more attractive network model for Memphis-area employers and their employees.


Read more about the acquisition in the NY Times

Posted by Cristie Travis at Friday, June 19, 2015

Potential Insurance Company Mergers Could Limit Employer Choices

Source: Morning Consult

6/21/15 Update: Cigna Rejects Anthem's $47 billion offer. Read why and more about other possible mergers in the latest NY Times article.

Are these possible mergers good or bad? Well, the answer is "depends". They would certainly limit employer choices as well as people purchasing individual insurance or insurance through the exchanges. On the other hand, larger insurance companies may be able to negotiate more favorable financial arrangements with the health care provider industry that is continuing to consolidate.

Read more about possible mergers:

Wall Street Journal (subscription required)

LA Times

Posted by Cristie Travis at Friday, June 19, 2015

MBGH & Methodist: Innovation Has Been the Key

Thinking back over the MBGH-Methodist Healthcare relationship, the first word that comes to mind is “innovation”. In many ways, Methodist has been a “Mikey” for MBGH. You remember “Mikey”, that little boy at the breakfast table in commercials that is willing to try anything for breakfast. Some highlights from the list of “Mikey-like” innovations with MBGH include:
  • The first worker’s compensation PPO network for self-insured employers in the region.
  • The first CAHPS survey in the nation which captured employer’s experience with the MBGH/Methodist worker’s compensation PPO network.
  • The first health system to implement internal quality improvement processes in reaction to MBGH’s 1998 Hospital Report Card on cardiac care.
  • The first roll-out of The Leapfrog Hospital Rewards program in the nation. Cigna ended up implementing a bonus pool for Methodist based on their performance on key Leapfrog safety and quality measures for their entire book of business which gained national recognition and became a model of other pay-for-performance programs nationally.
  • The first, and still only, health system in Memphis to post their detailed results from the Leapfrog Hospital Survey and Hospital Safety Score on their website. 

MBGH and Methodist have also collaborated on the University Medical Center Alliance (Memphis’ own version of the Institute for Healthcare Improvement), launching of the Healthy Memphis Common Table, and implementing the CDC’s Diabetes Prevention Program for their employees. About seven years ago, Methodist provided input into how to help them and other employers create a culture of health at the worksite, which is now a key component of MBGH’s CEO Culture of Health initiative.

Over the past six years, MBGH has recognized the important role Methodist hospitals play in providing safe, high quality, cost efficient care in the greater-Memphis area, including:
  • Best odds of survival for abdominal aortic aneurysm repair, pancreatic resection, esophageal resection, and heart angioplasty
  • Cost of care for heart angioplasty
  • Reducing the number of babies delivered before they reach full-term
  • Improvements in ventilator-associated pneumonia
  • Receiving “Straight A’s” on the Hospital Safety Score (Methodist University Hospital and Methodist LeBonheur Germantown Hospital)
  • High risk deliveries
  • Creating and sustaining a culture of health that supports the health of their employees.

As is always the case, these innovations and recognitions don’t just happen. It takes the commitment of a strong leadership team to see the need and then act upon it. Cristie Upshaw Travis, MBGH CEO, remembers what happened after MBGH released the first hospital report card in 1998, “I will never forget the afternoon I picked up the phone and Maurice Elliott, CEO and President of Methodist, was on the line wanting to talk about the report card MBGH had just issued on cardiac care in Memphis. I expected the usual “your data are wrong” and high level marketing points, but instead we spent two-hours going through every data point. The bottom line was that Methodist had been comparing their performance to other Memphis-area hospitals, not to national best practices and was surprised at the results. All of the Memphis health systems had similar if not bigger opportunities for improvement, but Methodist was the one that wanted the details so they could jump on improvement.”

From the early days of working with Maurice to our work with Gary Shorb, Donna Abney, Bill Breen, Ed Rafalski, Mitch Graves, Donna Winfrey, Jane Van Deren and others there has been a common commitment to innovation focused on improving quality and affordability of care for patients first and employer purchasers second.

MBGH thanks Methodist LeBonheur Healthcare for being a special sponsor for our 30th Anniversary and we look forward to working together as we start our next 30 years.
Posted by Cristie Travis at Monday, May 18, 2015

Opioid Abuse Costing Employers Billions

According to a recent study released by Healthentic and an article in Employee Benefit News, lost work and productivity due to opioid abuse account for $10 billion. 13% of the opioid users accounted for 92% of the employer costs. 

What should you do?

Insist on conservative prescribing approaches from your health plans and participating physicians

Use HIPAA-compliant tools to identify abusing employees 

Increase and ensure confidential access to treatment

Click here to read the EBN article and access the report here.

Posted by Cristie Travis at Friday, May 15, 2015

Check Out Latest Memphis Hospital Safety Scores

The latest Hospital Safety Scores for Memphis-area hospitals are out! Results of interest include:

  • The Regional Medical Center improved its score moving to a D.
  • Methodist North and Methodist South moved back to the Bs they have had in previous results. 
  • For the first time, Baptist Collierville had enough volume to receive it's own score, which was a C.

The rest of the scores remained the same as in Fall 2014: 

Methodist University: A
Methodist Germantown: A
 Saint Francis Memphis: A
 Saint Francis Bartlett: A
 Baptist Memphis: C
 Baptist DeSoto: C 

You can now check out all the past scores for Memphis area hospitals on the website. Select the hospital you are interested in and click "Show Past Grades".

These hospitals have received A's on all of the Hospital Safety Scores since the beginning in Spring 2012:

Methodist University

Methodist Germantown

Saint Francis Memphis

Click here to see the details on Memphis-area hospitals as well as more than 1,500 other hospitals across the country.

Posted by Cristie Travis at Thursday, May 14, 2015

Radical Approach to Hospital Bills: Set Your Own Price

According to Kaiser Health News, May 13, 2105:

 "A small benefits consulting firm called ELAP Services is causing commotion by suggesting an alternative: Refuse to pay. When hospitals send invoices with charges that seem to bear no relationship to their costs, the Pennsylvania firm tells its clients (generally medium-sized employers) to just say no."

"Instead, employers pay hospitals a much lower amount for their services — based on ELAP’s analysis of what is reasonable after analyzing the hospitals’ own financial filings."

Needless to say, this approach is disrupting the conventional approach to hospital payments.

In this approach, employers and their TPAs don't have contractual arrangements with hospitals and employees are free to go to any hospital. In other words, there are no pre-defined networks or PPO-type arrangements. According to Kaiser Health News, "Employers detail the reimbursement process in documents establishing how the plan covers workers. That gives it legal weight, ELAP has argued in court. ELAP agrees to handle all hospital bills for an employer and defend workers from collections in return for a percentage fee tied to total hospital charges."

Click here to read the article.

Posted by Cristie Travis at Thursday, May 14, 2015

Hepatitis C Virus Surges in Appalachia, Including Tennessee

The CDC found that hepatitis C cases increased 364% from 2006 to 2012 for residents ages 12-29 in the Appalachian states of Tennessee, Kentucky, West Virginia, and Tennessee. Rural rates were more than double urban rates.

73% of those that responded to a survey regarding risk factors reported they had used intravenous drugs, primarily heroin and prescription opioids. 

Add this to the fact that Memphis ranks second in the country for hepatitis C cases per 100,000 population and it is clear Memphis and Tennessee are hot spots for hepatitis c virus and the new drugs that can now cure this disease.

MBGH is working with employers and specialty pharmacy management experts to develop a series of workshops to focus employers on these issues and develop strategies to manage the cost of specialty pharmacy while, at the same time, offering these and other high quality drugs to their employees and dependents. 

Look for the announcement of our workshops soon!

Posted by Cristie Travis at Tuesday, May 12, 2015

Clarifications Issued On Key Health Reform Coverage Requirements

Click here to print out a copy of the clarifications issued by HHS and DOL regarding key health reform coverage requirements, including:

Coverage of FDA-approved contraceptives

BRCA genetic testing

Sex-specific recommended preventive services

Well-woman preventive care for dependents

Colonoscopy anesthesia services

You can also click here to go directly to the DOL site.

Posted by Cristie Travis at Tuesday, May 12, 2015

CDC Focuses on a Healthy Workforce

2015 MBGH Annual Conference Topic: Effective Worksite Wellness Programs

MBGH CEO Culture of Health Initiative

The latest issue of Business Pulse: Healthy Workforce is now available and explores how the CDC can help employers maximize their worker health and safety while improving their profitability and productivity.  The piece links to many tools that employers may find of value including business-focused CDC resources, the Total Worker Health program and this interactive infographic. 

Check out the Essentials Elements of Effective Worksite Programs under the Resources tab and note that MBGH's CEO Culture of Health initiative completely aligns with these elements. Interested in learning more about this evidence-based program? Contact Cristie Travis at

The CDC Foundation is a non-profit organization that connects the Centers for Disease Control and Prevention (CDC) with private-sector organizations and individuals to build public health programs that make our world healthier and safer. The Foundation produces Business Pulse, a quarterly online series which offers useful CDC health resources to businesses, executives, employers and employees.

Posted by Cristie Travis at Tuesday, April 14, 2015

How Does Your Health Plan Treat the New Biosimilars?

2015 MBGH Specialty Pharmacy Management Workshop Topic (held April 1)

From the National Business Coalition on Health:

"Earlier this month, Novartis’ Zarxio was the first biosimilar product approved in the United States, ushering in a new era for the drug industry, consumers and third parties who manage medical and drug benefits. The introduction of cheaper alternatives to relatively complex biologic drugs has created confusion over the U.S. Food and Drug Administration’s approval process and specialty-related product availability to be used or marketed."

"For plan sponsors, this situation is not ideal and continues to cause confusion around timing as well as terms important to benefit coverage sought by members as patients for these new biologic/specialty products from manufacturers. In addition, pricing has not been determined but is unlikely to rein in rising specialty drug cost trends or improve current year spending on medical or pharmacy benefits in the U.S."

Cheryl Larson, vice president of our sister coalition, the Midwest Business Group on Health, and Randy Vogenberg, principal for The Institute for Integrated Healthcare, highlight questions employers should be asking related to biosimilars in their April 14, 2015 article in Employee Benefit News.  

1. Have a conversation with your pharmacy benefit management organization and/or health plan regarding their coverage approach or policy related to biosimilars. If you have questions about how biosimilars are different, ask them. 

2. Review your vendor contract and coverage of specialty drugs to determine the impact on current or future plan costs to your organization. 

3. Review your own plans’ drug use patterns and if this type of approval would make a cost savings difference to your members. 

4. Determine if this will make any difference on annual cost trend for the plan versus just the unit cost of a particular drug for an individual medical condition like cancer-related anemia. 5. Continue to advocate for full cost transparency on all specialty drug products by your vendors. 

 The full article published in Employee Benefit News can be found here

Posted by Cristie Travis at Tuesday, April 14, 2015

Cadillac Tax To Become 2016 Election Issue

MBGH Members Only Peer Roundtable Discussions: Strategies Being Implemented re: Cadillac Tax

The next time your CFO asks you to explain the Cadillac Tax just tell them it is a way to "equalize the way wages and health insurance are taxed. "

According to the April 13, 2015 article in Employee Benefit News, Jonathan Gruber, an MIT economist, explains "Health insurance is compensation and wages are compensation. They should be taxed the same. And they're not". Gruber believes that since health insurance benefits aren't taxed, the system encourages excessive consumption.

The Cadillac Tax, which goes into effect in 2018, is a 40% excise tax on health coverage that costs more than $10,200 for an individual or $27,500 for a family. It is estimated that about 1/3 of all employers will be subject to the tax if they don't make changes by 2018.

Michael Cannon, director of health policy studies at the Cato Institute, believes that because so many employers will be impacted, there will be political pressure to repeal it. However, such a move may result in all of the ACA being re-opened for reconsideration and repeal of other reforms.

Democrats are likely to be pressured more than Republicans since Republicans say "we hate taxes, we hate the ACA, we want to get rid of this tax". Additionally, union plans and unions will be heavily impacted by the tax and will pressure for its repeal as well, putting more stress on the Democrats.

Read the complete article here.

Posted by Cristie Travis at Monday, April 13, 2015

Private Exchange Enrollment Doubles in 2015

2015 MBGH Annual Conference Topic: Private Healthcare Exchanges!

According to an April 13,2 015 article in Employee Benefit News, Accenture data shows that enrollment in private exchanges doubled from 3 million in 2014 to 6 million in 2015.

Accenture projects that by 2018, the first year of the Cadillac Tax, 40 million will be enrolled in private exchanges.

Although most of the growth in 2015 was in the mid-market segment, Accenture believes that more large employers, who have been waiting to see what happens in the private exchange market, will fuel future growth. 2018 will be a pivotal year and with 1/3 of employers being impacted by the Cadillac Tax, Accenture predicts that larger employers will have exhausted traditional cost cutting strategies and moving to the exchanges will be the remaining strategy to get them below the tax level.

Read the entire article here.

Posted by Cristie Travis at Monday, April 13, 2015

MBGH & Baptist Redefined Providing Health Benefits in Memphis

Thirty years ago, a small, but mighty, group of employers came together to commiserate about the high cost of health care in Memphis. They commissioned a special study that showed not only were their costs high, but there didn’t seem to be a rationale for how rates were set and there were vast differences, some as high as 80%, between what hospitals charged for the same service. 

Deciding that unless they became more active purchasers nothing would change, these employers, joined now by others, formed the Memphis Business Group on Health and decided to pool their lives and invited health systems to bid on their business. No doubt this decision caused quite a stir among health care providers and it was certainly disruptive.

But, what would the response of the health systems be? Would any system actually propose, or would they all sit it out and hope this new activism would just fade away?

Baptist Memorial Health Care stepped up to the plate and said they were ready to forge a relationship with MBGH. None of the other systems responded to the request for a proposal in 1987, but did throw their hats in the ring in 1989 and every bidding year afterwards.  Employers working directly with a health system literally redefined what it meant to offer health benefits in Memphis. This was a first for both MBGH and Baptist and actually was an early “first” nationally, as business coalitions were being formed around the country to reduce the cost and improve quality and accessibility to health care services.

The group purchase arrangement was not only innovative and disruptive at the time, but also for how it evolved over the next 12 years. Just a few of the most significant innovations were:
  • Agreeing contractually to report quarterly on the quality of care provided by Baptist compared with national benchmarks 
  • Moving away from a discount off fee-for-service to per diem and case rates for inpatient care and ambulatory surgical procedures
  • Providing access to MBGH’s group pricing to smaller businesses through MBGH’s fully-insured Business Group Health Insurance Alliance
As you can see MBGH and Baptist partnered on implementing what is now referred to as “value-based purchasing” at least 10 years before it became a national trend.

Over the past six years, MBGH has recognized the important role Baptist hospitals play in providing high quality, cost efficient care in the greater-Memphis area, including:
  • Best odds of survival for heart bypass, aortic vale replacement, pancreatic resection, and esophageal resection
  • Reducing the number of babies delivered before they reach full-term
  • Improvements in catheter-associated urinary tract infections
  • Creating and sustaining a culture of health that supports the health of their employees.
But, as Cristie Upshaw Travis, MBGH CEO says, it is not only about what MBGH and Baptist accomplished together; it is also about the people of Baptist.

“Being the daughter of a physician that practiced at Baptist for over 40 years I have always felt at home there. An especially poignant example of how this personal relationship played out was Steve Reynolds’s invitation for me to be the keynote speaker at the annual meeting of the Baptist medical staff when my Daddy would be recognized. That thoughtfulness has been there in our working relationship as well. From the early days working with Steve Reynolds, Bob Gordon and Mike Clement to our work with Jason Little, David Elliott, Beverly Jordan, Dana Dye, Anita Vaughn, Nancy Averwater and others there has always been a common commitment to putting employees and patients first and, I am glad to say, we have had some fun along the way.”

“Baptist is proud to be a long-term partner with the Memphis Business Group on Health,“ said Jason Little, president and CEO of Baptist Memorial Health Care. “Being MBGH’s first partner, we have always taken best clinical practices and quality excellence very seriously. We look forward to our continued joint work to help improve the health of those in the communities we serve.”

MBGH thanks Baptist Memorial Health Care Corporation for being a special sponsor for our 30th Anniversary. It just wouldn’t be the same if our first partner in this journey were not there to help us blow out the candles on August 20! Thank you Baptist.
Posted by Cristie Travis at Sunday, April 12, 2015

How To Develop a Culture of Health For Successful Worksite Wellness Programs

"There is considerable debate about whether worksite wellness programs are effective in improving health and in reducing health benefit costs. Supporters argue that if employees are healthier they are less likely to develop chronic diseases that are linked to lifestyle choices. Skeptics counter that many worksite wellness approaches actually increase costs and don’t deliver on the promise of reducing health benefit cost trends. Both of these viewpoints can be correct, especially if the issue is effective execution of worksite wellness programs.   

If worksite wellness programs are implemented merely as cost control measures laid on top of, or even integrated into, health benefits and are not a reflection of a core value of the organization, then they are likely to be less effective. When these same programs are wrapped within a culture of health they become a part of the fabric of the organization and engage employees more effectively."

Click here to read the rest of the article from HR Professionals Magazine that answers these questions:

  • What is a culture of health?
  • What would your organization look like if you had a culture of health?
  • How do employers create a culture of health?
  • Are others creating cultures of health?

The article, by Cristie Upshaw Travis, MBGH CEO, Dr. Kathy Tuberville of the Fogelman College of Business and Economics at the University of Memphis, and Renee Frazier, Common Table Health Alliance CEO, ends with a call to action for more employers to build cultures of health to strengthen the effectiveness of their worksite wellness programs.

Posted by Cristie Travis at Monday, April 6, 2015

The Y Leads by Example in the CEO Culture of Health Initiative

The YMCA of Memphis & the Mid-South is one of our newest CEO Culture of Health participants, having just joined in 2015. Believe it or not, they have already met the requirements for the Small Starts @ Work program and are officially a Healthier Tennessee Workplace!

Now you may be saying to yourself, “Well, it was easy for them, they are in the business of helping people get and stay healthy.” Cleo Griffin, Corporate Relationship Director for The Y, will quickly tell you that it is not easy, even for them. "The most responsible action was for us to offer our employees free Y membership so they can also take advantage of the programming we offer to help lead a healthier life. Thereafter, we had to be intentional about the behaviors that influence a culture of promoting the health of our team members”.  

Some of the other steps the Y has taken include: 

Offering free biometric screening through their health insurance benefits; 

Providing the Diabetes Prevention Program as a covered benefit under their staff health insurance plan;  

Giving a healthy tip at the beginning of team meetings; 

 Adopting water as the exclusive beverage offered to staff; 

 Changing their vending machine options; and 

Giving employees a health-related item when they exercise at least 12 times a month.   

A theme that runs through the Y’s approach to both employee health and wellness, and in their work to promote and support the health of Memphians, is removing barriers that stand in the way of people living healthier lives. Cost is often a significant barrier and by offering free Y memberships to their employees this barrier is removed.   The Y also works with businesses across the region to make this same benefit available to their employees by offering packages to employers who help subsidize the cost of Y membership for their employees. But even if the employer doesn’t subsidize membership, employee membership rates are based on their annual household income, making the Y financially accessible to lower wage earners. 

Other barriers the Y works to remove include:   

Convenience: There are 9 locations throughout the Mid-South; 

Child Care: The Y offers free child watch while employees workout; and  

Time: Ys are open early in the morning until late at night.    

But the Y is not just about working out and exercising. Other programs businesses may be interested in include the Diabetes Prevention Program, the Corporate Games, and for a small fee they can come to your worksite to present health topics for your employees.   For more information on the Y and ways in which they can support your employee health and wellness programs, click here.

Posted by Cristie Travis at Friday, April 3, 2015

CVS Urges Cost Controls For New Cholesterol Medications

Citing the concern that eventually 15 million patients at an annual cost of $150 billion of a new class of cholesterol medications, CVS Health warned that the cost of these new medications could overwhelm the U.S. health care system "if rigid cost control mechanisms are not put in place".

According to Reuters, CVS negotiates drug pricing for 65 million through contracts with employers and health plans.

The concerns around cholesterol medications are closely following criticism regarding the new Hepatitis C drugs, which may cost up to approximately $94,500 for a course of treatment. But unlike Hep C drugs which are effective with one course of treatment, the new cholesterol medications are essentially taken for life and significant annual financial implications for patients undergoing treatment and employers and plans covering the cost of that treatment.

Express Scripts also voiced concerns although their cost estimates are somewhat lower than CVS estimates.

Learn more about specialty pharmaceutical management on a February 26 webinar and in-person at a 1/2 day workshop in Franklin, TN on April 1. Email Cristie at for more information and registration details.

Read the Reuters article.

Posted by Cristie Travis at Wednesday, February 18, 2015

Scope of Wellness Programs Growing

MBGH's CEO Culture of Health is growing rapidly with 6 new participants so far in 2015. We are now at 60 participating organizations with over 66,000 employees. Contact Cristie at for more information on the complimentary benefits available to you from MBGH. And, here are the survey results from the International Foundation for Employee Benefit Plans (IFEBP) 2015 Worksite Wellness Trends survey. As you will see, having a culture of health at the worksite pays off!

Benefits Expanding To Support Social, Community and Mental Health 

Brookfield, Wisconsin – Celebrating a birthday, rolling up the sleeves for a community volunteer project and taking that extra day of vacation are probably not the first activities that come to mind concerning workplace wellness. However, less traditional benefits are quickly taking the stage as top wellness initiatives, according to the International Foundation of Employee Benefits Plans' recent surveyWorkplace Wellness Trends.

More traditional wellness initiatives like health risk assessments and flu shots remain popular among workplaces, but the International Foundation noticed a growing emphasis on more non-traditional initiatives like mental health coverage, vacation time and tuition reimbursement.

According to the survey, top non-traditional wellness initiatives include:

Vacation time/time off use is encouraged (66 percent)

Mental health coverage (63 percent)

Tuition reimbursement (63 percent)

Community charity drives (57 percent)

On-site events/celebrations (50 percent).

Some of the more unusual offerings emerging are discounted or free wearable tracking devices, themed dress-up days, game leagues, financial education and workplace design changes like collaborative work spaces, standing/treadmill desks and walking loops.

Top traditional wellness initiatives include:

Flu shot program (71 percent)

Smoking-cessation program (54 percent)

Health risk assessments (51 percent)

Health screenings (50 percent)

Wellness competitions/fitness challenges (42 percent).

Organizations are offering wellness initiatives for different reasons—59 percent offer wellness primarily to invest in/increase worker health and engagement, while 41 percent primarily aim to control/reduce health-related costs. 

As organizations embrace both traditional and nontraditional wellness initiatives, it is clear that their efforts are creating results."Employers are taking a greater interest in the social and mental well-being of their employees," said Julie Stich, CEBS, Director of Research. "Both traditional and nontraditional wellness benefits are creating the return on investment employers are looking for in their workplace wellness programs."

Of the responding organizations with wellness initiatives, about one in four (26 percent) is analyzing the return on investment of their wellness program. Proof of wellness results is in uniquely high demand – just four percent of organizations that calculate wellness ROI also analyze the ROI of other initiatives/benefits.

Among organizations analyzing and aware of their wellness ROI, 93 percent are achieving positive ROI –the average ROI per $1 spent is $3. Among organizations tracking more specific wellness efforts, 54% said wellness efforts have improved engagement, 45% said wellness efforts reduced absenteeism, and 38% said wellness efforts have positively affected their organization's overall bottom line.

 "Positive changes exist with the expansion of workplace wellness initiatives but what's even more exciting is the future emphasis of wellness-related offerings," said Michael Wilson, CEO of the International Foundation.  "Many organizations are moving beyond just physical health and are looking at the whole picture of employee well-being."

Click here for an infographic of major results.

About Workplace Wellness Trends Survey

Survey responses were received from 479 individuals from the U.S. and Canada, including benefits and human resources professionals, financial managers, and other professionals. Responding organizations represented a variety of sizes, regions and industries or jurisdictions. For complete results and more information visit

Posted by Cristie Travis at Wednesday, February 18, 2015

Get Intensive Training on Techniques and Skills to Manage Cost and Quality of Your Health Benefits

All Greater Memphis-area and West Tennessee HR and Benefit professionals are invited to attend the College for Value-Based Purchasing at Nissan North America in Franklin, TN on March 31-April 1, 2015.

Tuition costs are waived for MBGH dues-paying members and conference sponsors at the Supporter level and above (committed before March 13). For others the tuition for the College is $500. Attendees are responsible for all travel and overnight accommodations and meals not provided by the College.

The College for Value-Based Purchasing provides a practical, intensive program that focuses on benefit purchasing techniques and skills that emphasize improving value, quality-cost ratio and effectiveness of health care services purchased on behalf of employees.

The College is held from 8:00 am - 5:00 pm on March 31 (includes breakfast and lunch) and from 8:00 am - 12:00 pm on April 1 (includes breakfast). For the Franklin,TN session, College registration also includes an optional half-day session from 12:00-5:00 (including lunch) on specialty drug management on April 1 at no additional cost. 

The College has been approved for 10.5 (General) HR recertification credit hours. 

Click here for more College details including faculty, courses and schedule. Click here for information on the specialty pharmacy management session. Click here to register.

Posted by Cristie Travis at Wednesday, February 18, 2015

What the Anthem Breach Means to Employer Health Plan Sponsors

Thank you to the National Business Coalition on Health for sharing this Advisory with MBGH

Advisory Information from the law firm Davis Wright Tremaine LLP 02.09.15 By Adam H. Greene, Sarah L. Bhagwandin, Sean B. Hoar, Christin S. McMeley, Dipa N. Sudra, Rebecca L. Williams, and Anna C. Watterson 

NOTE: Even if you do not contract with Anthem, this is a great case study on your obligations and considerations if a breach ever occurs for you!

On Feb. 4, 2015, Anthem announced a data breach involving the personal information of more than 80 million individuals resulting from what it characterized as a sophisticated, targeted cyber-attack. 

Group health plans may be affected because Anthem: (1) provides insured health benefits; (2) administers health benefits for a self-insured plan; or (3) administers out of area/network claims. 

Employers, as plan sponsors on behalf of their group health plans, need to identify how the Anthem breach may affect them, if at all, and get their arms around what they need to do in response. The following is practical guidance on what employers need to know and do now and in the coming weeks to comply with their legal obligations. 

Does HIPAA apply? 

One question is whether the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) applies. HIPAA applies if the compromised information is “protected health information”—a broad category of individually identifiable health information that arguably includes demographic information when it is indicative of whether an individual is participating in a health plan.

Anthem has not used the term “protected health information” in its statements, but has indicated that “names, birthdays, medical IDs/social security numbers, street addresses, email addresses and employment information, including income data” were compromised, all of which may fall within the definition of the term. Anthem also has stated that “there is no evidence that credit card or medical information, such as claims, test results or diagnostic codes were targeted or compromised.”

Seemingly based on this statement, some at first reported that there has been no violation of HIPAA. These reports may be based on some confusion surrounding what information is protected by HIPAA and the definition of the term “medical information” under certain state laws, such as the California Confidentiality of Medical Information Act. A court in California recently ruled that “medical information” does not include “personal identifying information that is not coupled with that individual’s medical history, mental or physical condition, or treatment.” Anthem’s emphasis that no medical information was compromised may have been in reference to the California definition or something similar, and may become a key issue in the success or failure of any class action litigation under state law. 

We understand that class action lawsuits already have been filed, so it is not surprising that Anthem may be laying the groundwork for possible defenses. It is likely that the Anthem compromised information qualifies as “protected health information,” or “PHI” under HIPAA, which is a broader term than “medical information.” If this is the case, then Anthem, and in many cases employers, will clearly have breach notification obligations under HIPAA. 

What does this mean for employers under HIPAA? 

If the breached data is protected health information, Anthem will be required to provide breach notification under HIPAA. Notice obligations under HIPAA vary, depending on whether the compromised information relates to: (1) an individual policy; (2) a fully-insured group health plan; or (3) a self-insured group health plan. 

With respect to individual policies and fully-insured group health plans, Anthem may be the health insurance issuer. In these cases, a breach of unsecured protected health information likely requires Anthem to notify affected individuals, the U.S. Department of Health and Human Services (“HHS”), and the media. In these instances, the employer does not appear to have breach notification obligations under HIPAA. 

For self-insured group health plans, Anthem could be the third party administrator (“TPA”) of the plan. Under HIPAA, as a third party administrator, Anthem likely would be the group health plan’s business associate that must report a breach of unsecured protected health information to the health plan. The plan itself has the obligation under HIPAA to notify affected individuals, HHS, and potentially the media. This responsibility ultimately falls on the employer, as the plan sponsor. The employer, however, may delegate its breach notification obligations to Anthem, as its business associate. 

In the present case, delegation likely makes the most sense. Otherwise, a large number of self-insured plans would need to go through the time and expense of breach notification, affected individuals may confusingly receive multiple notifications related to the same incident, and government regulators would need to wade through a large number of breach reports related to the same incident. A self-insured group health plan’s business associate agreement with Anthem may include and address delegation of breach notification responsibilities. If not, then formal documentation of any delegation may be required if the group health plan chooses to delegate breach notification to Anthem. Once an employer delegates the breach notification obligations to Anthem, it should obtain evidence on behalf of its self-insured health plan that HIPAA-required notifications have been made for the employer’s compliance records. 

While HIPAA requires breach notification without unreasonable delay and in no case later than 60 days, it may be reasonable for Anthem to delay notification for the moment while it investigates the breach and coordinates notifications. Employers may need to await instructions from Anthem regarding how breach notifications may be coordinated. 

How will state law apply? 

State laws may present similar issues. For example, 47 state breach notification laws, plus the District of Columbia and two U.S. territories, require the non-owner of data to notify the owner of the data if there is a breach of certain information, including social security numbers. 

When Anthem is acting as a TPA, it may be treated as the non-owner of the data and have an obligation to report to the owner of the information. Ultimately, under these state laws, the self-insured group health plan, as the owner of the data, may need to notify affected individuals and, possibly, regulators and credit reporting agencies. As with HIPAA, employers who maintain self-insured plans that use Anthem as their TPA may be well served by delegating state breach notification obligations to Anthem. 

So what should employers do now? 

If your organization has a self-insured group health plan and uses Anthem as a TPA, there are a few steps that you can take while Anthem continues its forensic investigation:  

(1) Notify employees of the current breach information that Anthem has provided (available at; 

(2) Educate employees to be on the alert for phishing scams or similar activities that may take advantage of the Anthem headlines to try to obtain personal information (Anthem has indicated that it will contact individuals by U.S. mail, so employees should be wary of any emails or other electronic communications claiming to relate to the Anthem breach); 

(3) Determine whether you (the employer) have breach notification obligations under HIPAA and state law (such as the plan sponsor of a self-insured plan with Anthem acting as the TPA); 

(4) If you have breach notification obligations, review whether the notification obligations have been contractually delegated to Anthem, such as in the business associate agreement; 

(5) If breach notification obligations have not already been contractually delegated to Anthem, consider whether to formally delegate those obligations to Anthem now; 

(6) Coordinate with your Anthem representative over the coming weeks to address who will provide any breach notifications that may be necessary and verify that the notification will be sufficient to meet your obligations under the law; 

(7) Create an internal security incident report to demonstrate that you are aware that a security incident affecting the group health plan has occurred, and document the actions that are being taken and the basis for any delay (e.g., that you are waiting on more information from Anthem); and 

(8) Once any required breach notifications have been made, ensure that you have some evidence (such as information from Anthem) demonstrating that the necessary breach notifications to affected individuals, HHS, the media, and potentially state regulators and credit reporting agencies have been made. 

For any questions, feel free to contact any of the authors of this advisory, any of the attorneys identified as “Related People” on the right, or the attorney with whom you normally work. Disclaimer: This advisory is a publication of Davis Wright Tremaine LLP. Our purpose in publishing this advisory is to inform our clients and friends of recent legal developments. It is not intended, nor should it be used, as a substitute for specific legal advice as legal counsel may only be given in response to inquiries regarding particular situations.

Posted by Cristie Travis at Wednesday, February 18, 2015

From Our Blog

Say Hello

Please feel free to drop us a line via the button below. We try to respond to every email we receive.

Stay Connected

Join the MBGH community and keep up to date with issues concerning Memphis healthcare.

Facebook Twitter LinkedIn Feed