2021 Aligned Sourcing & Contracting Toolkit: New Tools for a New Decade

In 2020, COVID-19 changed the health care system in ways many thought were impossible.  Despite the glimpse of light at the end of the tunnel, COVID-19 will have longer-term impacts on market dynamics, payment and delivery reform, and many other health care strategies.

Given these implications, CPR revamped the Aligned Sourcing & Contracting toolkit components prior to this year’s re-release of these resources, by brainstorming what we believe should be priorities for employer-purchasers as we exit the pandemic.

We believe that self-insured purchasers continue to have the opportunity to push health plans to drive higher quality and more affordable care for their organizations and their covered populations.  When purchasers band together to create a collective set of demands, health plans have a business case for championing real and sustained improvements in health care quality and affordability.

By using CPR’s Aligned Sourcing & Contracting toolkit, purchasers can more effectively push health plans to implement the strategies and services they 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 renewal quote from an incumbent health plan, and when incorporating language into the final Administrative Services Only (ASO) agreement.

Included in this toolkit

  • 2021 Health Plan Request for Information (RFI):  CPR’s RFI serves as a companion to a general sourcing tool, which you can issue to prospective health plans during the health plan selection process.  It outlines questions to ask health plans on a wide range of issues and high-value health care strategies, including:
    • Combating high and rising prices
    • Addressing provider market power and competition
    • Enhancing price and quality transparency
    • Reforming payment and care delivery
    • Innovating with benefit and network design
    • Improving population health and increasing health equity
    • Improving maternity outcomes
    • Comprehensively reporting and collaborating

In addition, the RFI directs users to supplemental CPR question sets covering accountable care organizations, bundled payment, mental health, price and quality transparency tools, total joint replacement, genetic testing, serious illness care, and data warehousing and analytics.

  • 2021 Renewal Questionnaire: If you are a purchaser who is not conducting an RFI, this resource allows you to track the progress of your incumbent health plan(s) by asking informed questions when soliciting a fee or premium quote for the next Plan Year. This document includes an abbreviated question set on many of the same categories in the RFI:
    • Combating high and rising prices
    • Addressing provider market power and competition
    • Enhancing price and quality transparency
    • Reforming payment and care delivery
    • Innovating with benefit and network design
    • Improving population health and increasing health equity
    • Comprehensively reporting and collaborating
    • Supporting purchasers through COVID-19 and beyond

You can also access the Renewal Questionnaire as a stand-alone item.

  • 2021 Model Contract Language: This model contract offers language that you can use with your health plan to set expectations in critical areas of interest.  We recommend attaching this language as an addendum to your own health plan ASO agreement.  The model contract language is organized by the following sections:
    • Combatting high prices and stimulating competition
    • Transparency
    • Provider payment and care delivery reform
    •  Benefit and network design
    • Health disparities and care improvement
    • Participation, collaboration, and reporting

View the June 23, 2021 recording that discusses the importance of purchaser alignment and reviews these resources.


As a health care purchaser, you can log in to get FREE access to the Toolkit!

No account? No problem.  Click HERE to create your Catalyze.org account. Or click Log In > Forgot Password in the upper-right hand corner to reset your password.


 

 

Type:
Sourcing & Contracting Tool
Cost:
$399
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