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.
In a prior blog article on the 2021 KFF Employer Health Benefits Survey, we noted that employers are in the eye of a hurricane and will have to confront some painful tradeoffs when costs spiral again. But the significant exceptions to employers’ “wait and see approach” to health care benefits during the first year of the COVID-19 pandemic are in the areas of telehealth and behavioral health, including at the intersection of the two.
Suzanne Delbanco speaks with Jason Richmond, Head of Consultant Relations at Ginger, a digital mental health care provider. Jason Richmond explores the supply and demand imbalance between mental health patients
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
“What’s great about [direct contracting] relationships is they allow for an employer to work directly with a health system in developing a solution that’s specific to their employee base. They can design programs that address their specific needs, such as addressing diabetes issues within their employee population or behavioral health. In return, the health system expects employers to develop benefit plans and contribution strategies that steer their employees to that health system.”
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.
The digital health explosion has left many employers wondering how to prioritize which bright, shiny new solution to chase, how to discern which solutions are really fool’s gold, and how to get the most from an existing program.
CPR’s Program Director, Andréa Caballero, chats with Stephen Furia, Senior Vice President, Population Health at Mount Sinai Health System. The Population Health division is the business unit within Mount Sinai that works directly with employers and other health care purchasers, providing an array of services including primary care focused near-site health centers, Centers of Excellence arrangements for specialty care, executive health programs, and, more recently, assisting employers in responding to the COVID-19 pandemic.
Andréa Caballero, MPA, speaks with Linda Schwimmer, JD, President and CEO of the New Jersey Health Care Quality Institute (Quality Institute) to learn about a pressing issue: the health of New Jersey’s Small Group Insurance Market.
Suzanne Delbanco connects with Chris Cigarran, CEO of Imagine Health, an alternative health plan offering curated provider networks in select markets across the country. Prior to Imagine Health, Chris built the employer and government sales division of a wellness company and has also served as Chief HR Officer.
Suzanne Delbanco speaks with Peter Lee, Executive Director of Covered California Health Exchange, to discover how Covered California plans to accelerate positive change in the health care system. Hint: Alignment with other large health care purchasers is at the center.
Health equity provides the principles and framework to address the maternal health disparity crisis in the U.S. The premise is simple: By improving care for those most likely to face poor outcomes, stakeholders can ensure that the health system is preventing poor outcomes for all patients.
The health care marketplace continues to evolve, as health care organizations consolidate and experiment with new value-oriented models. As these new strategies emerge to drive high-value purchasing, there has been
Listen in as Mark Fendrick, Director of the University of Michigan Center for Value-Based Insurance Design and a practicing general internist, provides an overview of the new developments in the
Unpacking the complexity of high-performance network design The National Business Group on Health (NBGH) predicted that by 2018 a staggering 61% of employers would offer narrow or high-performance networks (HPNs).
Suzanne Delbanco chats with Frank Opelka, MD, FACS, Medical Director for Quality and Health Policy with the American College of Surgeons, to understand how surgeons across the United States view
Take a moment now to think of all your monthly memberships and subscriptions – we’re willing to bet there’s at least one that you’re likely not using to its full
