The Case for Consistent Purchaser Demands
When faced with a collective purchaser voice, health plans have a business case for changing how they serve their customers and push for improvements in the quality and affordability of health care. CPR’s Aligned Sourcing & Contracting Toolkit does just that. Since 2013, it has unified the voice of progressive purchasers. By using CPR’s health plan selection, renewal, and contracting language, you can more effectively push health plans to implement the strategies and services you need to succeed as a high-value purchaser.
How to use the toolkit
This toolkit includes editable documents that you can use to set health plan expectations during the health plan selection, renewal, and contracting phases. Specifically, use these templates for the initial request for information, when requesting a quote from an incumbent health plan, and when incorporating language into the final contract.
Included in this toolkit
- 2019 Health Plan Request for Information (RFI): CPR’s RFI serves as a companion to a general request for information you can issue to prospective health plans during the health plan selection process. It outlines what you should ask health plans about on a wide range of high-value health care strategies. including delivery and payment reform, price and quality transparency, and benefit and network design. In addition, the RFI includes questions related to health plan efforts with ACOs, and to improve clinical areas, such as maternity, pharmacy, behavioral health, total joint replacement, genetic testing, and serious illness care.
- 2019 Model Contract Language: This model contract includes language that you can use with your health plan to set expectations for value-oriented payment and delivery, quality and price transparency, innovative benefit and provider network designs, as well as reporting results of these efforts. You can incorporate some or all of the language into your own health plan contracts.
- NEW IN 2019! Renewal Questionnaire: If you are a purchaser who is not conducting a RFI, this new resource allows you to track the progress of your incumbent health plan by asking important questions when soliciting a fee or premium quote for the next Plan Year. This document includes check-up questions on delivery and payment reform, benefit and network design, and price and quality transparency among other topics.
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