Catalyst for Payment Reform

Catalyst for Payment Reform Survey Identifies Employers’ Key Hurdles to Disruptive Health Care Purchasing Strategies

Media Advisory: Catalyst for Payment Reform Survey Identifies Employers’ Key Hurdles to Disruptive Health Care Purchasing Strategies

Research finds broker conflicts of interest, complexity of employee support 
and communication among biggest barriers.

BERKELEY, CA – February 14, 2024 – To identify the obstacles to disruptive purchasing faced by employers and other health care buyers and offer strategies to overcome them, the non-profit Catalyst for Payment Reform (CPR) released the results of its latest national purchaser survey.

“We are in a health care price crisis,” said Guy D’Andrea, executive director for CPR. “Rising health care costs are harming people and families every day. Employers have maxed out cost-sharing to their employees, and premiums continue to rise. Disruptive strategies and innovative solutions to are needed if purchasers are to provide affordable and comprehensive health care for their employees.”

CPR defines disruptive purchasing as a suite of strategies deployed by employers and other health care purchasers to regain control of the cost and quality of care delivered for their employees and their families. Disruptive purchasing strategies examined as part of this research include advanced primary care, centers of excellence, direct contracting, high-performance and narrow networks, navigation support, on- and near-site clinics, reference-based pricing and removal of provider(s) from a network.

Highlights of the survey of human resource/benefits staff include:

When asked how the term ‘disruption’ is perceived within their organizations, respondents said employees were more likely to perceive the term as negative (74%) compared to human resource/benefits staff (17%) and leadership (22%).

Top disruptive purchasing strategies implemented by purchasers are centers of excellence (53%), navigation (49%), advanced primary care (43%), and high-performance networks (38%).

The most significant strategic hurdle is broker/consultant conflicts of interest as 81% noted it as moderate to significant. A vendor’s inability to demonstrate return on investment is a moderate to significant hurdle for 76% of respondents and 73% indicate strategic buy-in from leadership is a moderate to significant hurdle.

From an operational perspective, 92% rated the complexity of member support and communications as a moderate to significant hurdle, 86% rated coordination with external parties a moderate to strategic hurdle, followed by internal bandwidth (83%).

“Employers and other health care purchasers are running a steeplechase race when it comes to buying health care benefits,” said Ryan Olmstead, CPR director of member services. “They develop a multi-year plan toward greater value, but near-term obstacles crop up that divert them from achieving their goals. Our hope is that by identifying the biggest hurdles and success factors to overcome them in this research, the obstacles will be easier to foresee and address, resulting in greater implementation of these disruptive strategies.”


Between July and September 2023, CPR surveyed human resource and benefits staff with 63 purchasers responding. The participants represented a cross-section of mid- to senior-level staff from organizations of diverse sizes ranging from less than 500 employees to tens of thousands. CPR also convened purchaser and multi-stakeholder focus group sessions. The research was sponsored by Alera Group, Centivo and Transcarent.

The full report, The Great Steeplechase: Purchaser Hurdles to Cost and Quality of Care Management and How To Overcome Them, with findings can be downloaded here.

About CPR

Catalyst for Payment Reform (CPR) is a national, independent, nonprofit organization with a mission to catalyze employers, public purchasers, and others to implement strategies that produce higher-value health care and improve the functioning of the health care marketplace. For over a decade, CPR has championed efforts to rebalance health care market power and hold the delivery system accountable for outcomes, patient experience and affordability