Catalyst for Payment Reform

Market-Shaping Enterprises: New Vendors Want to Rescue Health Care

Market-Shaping Enterprises: New Vendors Want to Rescue Health Care

CPR evaluated seven market-shaping enterprises (MSE) vendors and interviewed industry experts to uncover how, why and whether these vendors can reshape the harmful incentives that underpin rising health care costs.

At the end of 2022, purchasers find themselves in a world where health care prices rise unabated, where mega health systems profit while community hospitals starve for funds, and where the entities charged with negotiating on behalf of purchasers appear powerless to countermand market trends.  It’s five minutes to midnight and purchasers desperately need a hero: one that is strong enough to move markets, brave enough to challenge the status quo, and nimble enough to navigate through the obstacles that perpetually dog traditional health insurance carriers.  A new cache of vendors has recently entered the health care marketplace, looking to succeed where the traditionalists have fallen short.

CPR’s white paper Market-Shaping Enterprises: New Vendors Want to Rescue Health Care examines the evolution, mechanisms and strategy behind MSE solutions, and explores the most important questions health care purchasers should consider when evaluating an MSE vendor.

The report focuses on the following six strategies that vendors deploy to re-shape the health care market:

  • Alternative Payment Models
  • Reference-based Pricing
  • High-performance Networks
  • Centers of Excellence
  • Direct Contracting
  • Value-oriented Benefit Design

The report also covers requirements for core capabilities that all point solution vendor partners should offer as table-stakes for delivering high-value products to their employer-purchaser partners.

 Additional resources for health care purchasers and consultants:

  • Toolkit: The market-shaping enterprises toolkit includes RFI questions and specifications, and MSE solution evaluation template.  The toolkit is free to health care purchasers and CPR members.
  • Summary scorecards: Profiles of the 7 vendors who participated in CPR’s MSE study, which are available for purchase and free for CPR members.
  • Detailed scorecards: Verbatim responses from MSE vendors for the full set of questions included in the RFI, an exclusive resource for CPR members.
  • Virtual Summit: On October 11th, CPR hosted a 90-minute virtual summit to share key findings from our research, and invite panels of MSE experts and MSE customers to share their insight and experience.  A recording of the summit is available to health care purchasers for free, and to all others for a nominal fee.

To access the FREE report, please fill out the form below:

Type: White Paper