PBGH influences policy by providing Members with the information and resources necessary to navigate the complex policy and regulatory environments. We also draw on lessons from our Members’ extensive experience in improving the quality and affordability of health care to inform public policymakers.

2019 Key Policy Priorities

Advance value-based purchasing

  • Support innovative programs and policy changes that encourage public and private purchasers to move toward paying for value over volume, such as accountable care organizations and bundled payments

Reduce drug costs

  • Reduce barriers to the development and use of biosimilars and generic drugs
  • Prohibit “spread pricing” by pharmacy benefit managers (PBMs) and require PBMs to pass through 100% of rebates

End surprise medical billing

  • Protect patients from surprise medical bills with a benchmark payment solution for out-of-network care

Improve transparency of health care costs and quality

  • Establish a national all-payers claim database
  • Require transparent reporting from PBMs to plan sponsors
  • Remove gag clauses on the sharing of price and quality data by providers

Support a functional market

  • Prohibit anti-competitive contracting practices by providers that are used to gain market power and raise prices

Improve maternal health care

  • Advance programs that will help improve maternal health care quality and reduce maternal mortality and morbidity

Policy Principles & Statements

PBGH Statement on Legislation Aimed at Lowering Drug Costs
September 19, 2019

PBGH applauds initiatives by Speaker Nancy Pelosi and other members of the House leadership to reduce prescription drug costs.

PBGH on Surprise Medical Billing

Policy Resources