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Will health care be more affordable in five years?
On February 2, 2023 CPR gathered health care luminaries to discuss the most critical challenges we face – affordability, access, equity, adequate competition, transparency, quality and more.
We heard Christin Deacon, Principal Owner of VerSan Consulting, Suzanne Delbanco, Senior Advisor to Catalyst for Payment Reform, Dr. Mark Smith, Clinical Professor of Medicine at UCSF, and Dr. Reed Tuckson, Managing Director of Tuckson Health Connections debate the topic, “Will Health Care be Affordable in Five Years?”
In the world of TPAs and other point solution vendors, there are takers and shapers. Takers accept the health care market dynamics as they are and try to squeeze out a few extra dollars of savings with another round of discount negotiation thumb-wrestling or perhaps a shiny new app. Shapers, on the other hand, aren’t afraid to upend the status quo. They intrepidly adopt disruptive network and benefit design strategies that elevate high-value providers; they insist on holding providers accountable through alternative payment models; they hand purchasers the steering wheel by enabling direct contracting. Some of these vendors are TPAs, but others aren’t in the business of paying claims: that’s why we call them market-shaping enterprises.Buy
During this Virtual Summit, you’ll hear from sophisticated purchasers about how they use data to inform their strategy. Then, CPR will team up with benefits consultants to unpack the obstacles purchasers face in data ownership, access, and use, and potential solutions around the obstacles. Finally, you’ll hear policy experts describe the benefits and limitations of the hospital and payer price transparency rules in resolving some data access issues.Buy
Health Policy Developments Impacting Employer-Purchasers with Suzanne Delbanco, Catalyst for Payment Reform, Katy Spangler, Spangler Strategies and Tracy Watts, Mercer
In this webcast, CPR’s executive director, Suzanne Delbanco, describes how CPR and its members have helped to change health care using their influence in the market and how public policies have the potential to bring their efforts to the next level. Then, Katy Spangler of Spangler Strategies, updates attendees on the latest developments in DC around price transparency and surprise billing. Following Katy, Tracy Watts, Mercer, shares federal updates on telehealth payment and efforts to stem anticompetitive behavior by health care providers.
Learn what CPR found through an 18-month long investigation into aggregated health care purchasing, or the strategy where employ-led coalitions pool member plan volume to negotiate with local providers. You’ll also hear purchasers from around the country describe how they’ve pursued a strength in numbers approach to getting better health care value.Buy
Virtual Summit: Anchoring to Medicare – Can Reference Pricing Turn the Rising Tide of Health Care Costs?
What is reference-based pricing? In this virtual summit, CPR provides an overview of RBP: how/why it works, how the model evolved, and where it’s going next. Experts discuss the risks, rewards, and regulatory implications of RBP, and a panel of real-world purchasers who have implemented an RBP strategy talk about why they chose reference-based pricing, how it’s impacted their health spending, and lessons learned along the way.Buy
Join Jon Schloemer, Cargill’s Senior Consultant, Health and Welfare Plans / North America, and Jeff Wells, Marathon’s CEO and co-founder, as they discuss the successful partnership in their near-site health center program.Download
Join Sandy Sakaida, vice president of benefits and human resources planning for The Cheesecake Factory, and Dr. Nikole Benders-Hadi, medical director of Behavioral Health at Included Health as they discuss the current state of mental health needs in our society, and how The Cheesecake Factory is addressing the mental health needs of their workforce of more than 40,000 employees nationwide.Download
It’s that time of year again, and now more than ever employer-purchasers need to send a deliberate and direct message to the marketplace that they expect provider competition, more price and quality transparency, more reform in payment and care delivery, more innovative benefit and network design, more action in addressing health disparities, and better collaboration.Download
It’s no secret that teens today are under a great deal of stress and experience high levels of anxiety due to the demands of school, their jobs, extracurriculars, social life, and a general uncertainty about their futures. Catalyst for Payment Reform, in collaboration with Headspace Health, is excited to invite you to join our webinar, Fostering Teen Mental Health.
Over the past year, CPR has researched the barriers purchasers and their business associates encounter when they request data from a health plan or other vendor. We gathered information from a diverse group of stakeholders – employer-purchasers, vendors, consultants, and even health plans to inform a 360° view of data stewardship between purchasers and their business associates. This research culminated in the creation of a new suite of tools that purchasers can use to assess their TPA’s and other vendors’ willingness to “play nice” in the data sandbox. In January, we published these tools – Purchaser Tools for Breaking Barriers to Data Ownership, Access, & Use and hosted a virtual event – Data is the New Health Care Currency. Are Purchasers Getting Short-Changed.Download
Metro Nashville Public Schools buys health care for 18,000 teachers and their dependents, spending $100 million annually. Learn about Metro Nashville Public Schools’ direct contract bundled payment arrangement for maternity. Under the program, MNPS pays a bundled price to Vanderbilt University Medical Center covering everything from first prenatal visit, enhanced services like patient navigator support, the hospital delivery, and care through three months post-partum – all with zero out-of-pocket costs for the member.Buy
$mart $cripts is a population health improvement program designed to eliminate cost barriers to medications and provide coaching support to employees with certain chronic conditions. By implementing this onsite clinic supported program, Sargento has improved medication adherence and outcomes at no cost to employees.Buy
Learn how purchasers can align their asks and demands of health plans and other stakeholders in critical areas of interest to employers and other health care purchasers.
Topics include: high and rising prices, provider competition, transparency, payment and care delivery reform, and benefit and network design. This webinar features expert consultants from Willis Towers Watson: Jeffrey Levin-Scherz, MD and Population Health Leader, and Drew Hodgson, FSA MAAA and National Health Care Practice Delivery Leader.
Learn how UNITE HERE HEALTH’s health promoters provided vital ‘boots on the ground’ support for members throughout, and in the wake of, the COVID-19 pandemic. The role of a health promoter spans activities ranging from trust building within the community to health coaching, care coordination, and social work, among others. Plus, hear directly from a health promoter as they’ve transitioned to educating members about the COVID-19 vaccine.
Learn how the 32BJ Health Fund developed and launched its High-Value Maternity Network and accompanying Maternity Program in New York City and Northern New Jersey in July 2020. You’ll also hear a health system leader describe how this strategy benefits providers through increased volume and brand elevation.