Catalyst for Payment Reform

Marilyn Bartlett on Montana’s “Medicare Plus” contracting strategy

Marilyn Bartlett on Montana’s “Medicare Plus” contracting strategy

Recorded on February 28, 2020.

Listen in as Suzanne Delbanco speaks with Marilyn Bartlett, CPA, CMA, CFM, Senior Policy Fellow with the National Academy for State Health Policy (NASHP). Prior to joining NASHP, Marilyn served as administrator of the Health Care and Benefits Division for Montana’s state employee health plan where she led a successful effort to establish a “Medicare Plus” contracting strategy. The strategy brought the average price paid to hospitals to 230% of what Medicare pays, when previous payment levels ranged from 200-600% of Medicare prices. Marilyn examines the factors that helped her bold strategy succeed, including political pressure from the state legislature as well as the absence of large health systems who could more forcibly push back against the purchaser’s strategy. In addition to answering Suzanne’s questions about the effort that landed her a spot in Fortune’s World’s 50 Greatest Leaders list, Marilyn also shares anecdotes from her time as a CFO for a third-party administrator (TPA) and insights on how employers can implement more initiatives like Montana’s.


To examine Montana’s Medicare Plus contracting strategy within the context of other state-based activities to address rising health care costs, check out the 2020 report State Policies to Address Market Power by CPR and UC Hastings College of Law.

Leave a Reply

Contact Us


View Blog Archives