Employers and other health care purchasers – it’s time to step off of the sidelines and onto the field. Across CPR’s membership and broader audience, there has never been more innovation and agency among health care purchasers than there is today.
Suzanne Delbanco connects with Erin Fuse Brown to discuss the No Surprises Act and what employers should be paying attention to with regards to surprise billing protections.
CPR published a collective set of demands that purchasers should include in their ASO agreements. When multiple purchasers ask for the same thing at the same time, it broadcasts a powerful signal to TPAs on purchaser priorities. Among these aspirational yet foundational expectations, the delivery is in the details. Here are three provisions of note in CPR’s latest model contract language.
Suzanne Delbanco catches up with Niall Brennan, President and CEO of the Health Care Cost Institute (HCCI), to ask the tough questions on price and utilization data for employer-sponsored health care.
Getting these details right will determine if implementation of the No Surprises Act will not only protect patients from most high and unexpected medical costs but also help reduce the need for balance billing in the first place and keep prices in check.
Should employers impose COVID-19 vaccine mandates? The keyword here is “should” (“can” is a legal question that has already been largely answered and is not the subject of this blog). But “should vaccination be required” leaves room for debate. While bioethical analyses typically rely on multiple frameworks, this blog should be considered a primer on two of the ‘hallmark’ bioethical principles: autonomy and justice.
Back in October 2019, we published a blog post on the challenges of building a high-performance network (HPN). We landed on the conclusion that an HPN should be designed with sensitivity to
Will the updated penalties and clarifications proposed by CMS compel hospitals into compliance? The jury is out, but the impact of the proposed updated rules depends heavily on enforcement.
In this blog post, we offer best practices for vendors preparing for “case study” presentations in the direct-to-employer context.
First of all, why case studies? Case studies are empirical inquiries that investigate a phenomenon in a real-world context.
When the RBP vendor and provider “agree” on a rate, who pays the difference? The RBP vendor or the employer? It depends – and the outcome will likely be reflected in the vendor’s administrative fee.
Suzanne Delbanco catches up with CJ Stimson, MD, JD, the Senior Vice President of Value Transformation at Vanderbilt University Medical Center (VUMC), to discuss Vanderbilt’s direct contract bundled payment arrangement for maternity care with Metro Nashville Public Schools (MNPS).
Employers and consumers are eager for solutions that attack health care cost inflation at its root cause. One prominent strategy is using reference-based pricing (RBP) models that anchor commercial rates to Medicare, or some other rationalized external benchmark. Like so many health care innovations, reference-based frameworks encompass multiple branching models, and as such the term “RBP” has come to mean different things to different stakeholders.
This 10-day daily email series will guide you around CPR’s resource library so you’ll see the range of topics and product types that we cover. Introducing the “CPR Library Chocolate Box” in the form of a free treat, aka CPR resource, every day leading up to Valentine’s Day.
A tornado is what comes to mind when thinking about the future of alternative payment models (APMs). It’s not because the health care ecosystem (let alone APMs) are poised to wreak horrific destruction upon us all. Rather, the tornado analogy derives from the powerful and influential forces blowing the APM movement in multiple and conflicting directions.
CPR is grateful to both our guests and audience who have contributed to our Listening In (with Permission) podcast series. Since CPR launched the podcast in the spring of 2017,
The onset of COVID-19 brought new challenges to San Francisco Health Service System (SFHSS) in its mission to preserve and improve sustainable, high quality health benefits for City and County employees, retirees, and their dependents.
Would 2020 be the year that health care purchasers finally abandon broad PPO networks in favor of curated solutions like narrow, tiered or high-performance networks? Julianne McGarry review’s KFF’s 2020 Employer Health Benefits Survey to find out.
“What I see now is confusion, disorientation, uncertainty, and anxiety. That creates an opportunity, but it doesn’t provide a direction.” – David Blumenthal, President of The Commonwealth Fund, speaking at
Introducing new tools from CPR to standardize the evaluations of Centers of Excellence, High Performance Networks, Reference Based Pricing programs, Bundled Payments. Each tool is tailored to measure relevant program performance in terms of cost of care savings, quality outcomes, changes in utilization, and member experience.
What we’ve learned from health care economists, policy experts, and business leaders has begun to illuminate the contours of a new health care economy, re-shaped in the wake of the global pandemic.
