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\u201cIf operating on the wrong leg is called a \u2018medical error,\u2019 what do we call operating on someone who doesn\u2019t need surgery?\u201d That is a quote I have heard attributed to Jack Wennberg. It also crystalizes a theme I have been hearing a lot lately\u2014the idea that quality metrics in this country today assess care from basically a patient safety standpoint but they don\u2019t consider whether the patient actually needed the surgery or whatever in the first place. Or whether the outcome of the treatment matched an outcome the patient understood and had hoped for.

I get into this in depth, by the way, with Dr. Suzanne Clough (EP235); and I\u2019m going to get into it again in my upcoming interview with Dr. Marty Makary (EP242).

In this health care podcast, I speak with Olivia Ross. Olivia has a reputation as a \u201crock star in the employer coalition world,\u201d and I say this because it was a direct quote from an email I received after I mentioned that she was coming on the show. Olivia earned her rock star chops at the Pacific Business Group on Health (PBGH). Olivia is the associate director of the Employers Centers of Excellence Network, otherwise known as ECEN.

What Olivia has worked on at ECEN is to put together a network of centers of excellence (COEs), meaning provider organizations that have committed to prospective bundled care payments for services like orthopedic surgeries, oncology, and bariatric surgery. Not only do these organizations \u2026 well, not only have they demonstrated excellence, but they also have demonstrated that they only treat patients who are appropriate to treat.

Employers including Walmart, Lowes, and McKesson use this network. In my interview with her, Olivia discusses how the COEs are selected and exactly how employers intercept employees at the right waypoint along their patient journey, fly them or get them to travel to the COE, and then repatriate them back home with their local PCP (primary care provider) for follow-up care. I\u2019m not sure if repatriate is the right word to use there, but I\u2019m going to go with it.

Olivia Ross, MBA, MPH, is associate director of the Employers Centers of Excellence Network (ECEN) at the Pacific Business Group on Health (PBGH). Olivia oversees the ECEN program, a national, multi-employer initiative developed as part of PBGH\u2019s commitment to value-based purchasing.\xa0