Catalyst for Payment Reform

Bob Galvin revisits the state of payment reform

Suzanne calls up Bob Galvin, CMO of Blackstone and chairman of CPR’s board of directors, to follow up on their previous discussion on the state of payment reform. So where are we at? Progress is slow, yet steady — we’ve had rain delays, changing pitchers, changing managers, but the game isn’t over.

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Featured Experts who have advised our Members

Being a member of CPR is about so much more than being a leading national voice in the fight for more access, equity, and quality in health care. It’s about being a part of a team who band together to strategically push the health care system. How do members achieve this? CPR creates the space where members can engage with experts, health plans, and CPR staff to incubate trailblazing health care strategy.

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Dr. Jeff Wells speaks about advanced primary care and Marathon Health

Suzanne calls up Dr. Jeff Wells, CEO and co-founder of Marathon Health to talk about advanced primary care models and how it fits in with onsite and near-site clinic, and virtual care.

Suzanne and Jeff dive into the term advanced primary care and how it differs from prior terminology used to describe high-value primary care strategies. In addition, they discuss why there is a lack of primary care providers compared to most other developed countries and what the future looks like for primary care.

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Peter Lee on the last twenty years in health care reform

Suzanne calls up Peter Lee, the former Executive Director of Covered California to talk about the last twenty years in health care reform. He explains how many of the payment reforms executed in the commercial space have really been on the margins, and many employees are spending more for worse care than ever before.

So what’s the problem? Lack of real alignment on measures, and not enough dollars at play at the right level. “We focused a lot on provider level payment…not at the health plans. Health care is a team sport, if we aren’t making the quarterback of the team, the health plans, accountable for quality and value, nothing is going to happen.”

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Aneesh Chopra on Price Transparency and Data

Suzanne calls up Aneesh Chopra, Co-Founder and President of CareJourney, to talk about the current state of health care transparency policy and how the US is faring. So, what’s the mood on current regulations and government oversight? “The general feeling in the field is one of skepticism,” says Chopra, but he’s much more bullish on it. According to Chopra, based on research CareJourney conducted in partnership with Turquoise Health, “two-thirds of hospitals as of the spring of 2022…actually have meaningful, high-quality transparency data.” The question now is are we going to see this information put to use?

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Alice Hm Chen on Covered California’s commitment to health equity

Suzanne calls Alice Hm Chen, Chief Medical Officer at Covered California, and asks about her work in quality measurement and health equity.

As the nation’s largest state-based health insurance exchange, how is Covered California thinking about its responsibility to deliver equitable care to its member population?

“I think a key thing for everyone to embrace is, equity is quality…you won’t get to true high-quality care unless you are addressing equity.”

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Roslyn Murray on Value-Based Payment Models in the Commercial Sector

Suzanne Delbanco speaks with Roslyn (Roz) Murray, a doctoral candidate at The University of Michigan School of Public Health and former Catalyst for Payment Reform employee.

Roz delves into her first peer-reviewed paper in Health Affairs, which concludes that the evidence on commercial value-based payment models is mixed. This is the first systemic review of the quality, spending, and utilization effects of commercial models, extracting results from fifty-nine studies.

Suzanne and Roz dive into why there is such little research in the commercial sector on value-based payment and compare Roz’s findings to research done in the public sector.

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Has Price Inflation Got Your Attention? Carpe Diem!

On February 10, 2022 price inflation jumped by 7.5% over the past 12 months, its highest annual increase in 40 years.  For employers and other health care purchasers that monitor their claims cost and utilization data religiously (who doesn’t?), this news prompts questions from purchasers about how inflation will impact their future health care spend.

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Massachusetts Slams the Breaks on Mass General’s Expansion Plans: Insights into the Value of State Health Policy Commissions

The State of Massachusetts made headlines when its Health Policy Commission (HPC) launched what the press called “a double-barreled attack” on Mass General Brigham’s expansion plans. In the first of its one-two punches, the HPC concluded that Mass General’s $2.3B plan was “not consistent with the Commonwealth’s goals for cost containment.” 

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Alexandra Drane on Supporting Caregivers as Critical Care Partners

Suzanne Delbanco speaks with Alexandra Drane, Co-Founder & CEO of ARCHANGELS, diving into the critical role of caregivers and why they must be part of the clinical care team. She also discusses how ARCHANGELS’ Caregiver Intensity Index (CII) is designed to engage caregivers and help them see themselves in the role.

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December is wrapping up and the New Year is right around the corner. But just before looking ahead to 2022, CPR is taking one last look back at 2021. We’re highlighting the Top 10 podcasts and featured experts of this year. These insights are definitely worth revisiting (and remembering in the year to come!).

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Jo Porter Gives Suzanne the Scoop on All Things APCD

Suzanne and Jo discuss the recent growth in APCDs across the country, renewed federal interest in APCDs, how states are collecting and sharing the information in their APCDs, and data barriers. Suzanne and Jo also discuss the benefits of APCD data for employers and other health care purchasers looking to create high-value benefits and health care programs for members.

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