Catalyst for Payment Reform

market power

Doug Aldeen takes a deep dive into Reference-based Pricing

Julianne calls up Doug Aldeen, ESQ an ERISA Healthcare Attorney and General Counsel to discuss the Reference Based Pricing (RBP) landscape, specifically how RBP has evolved over time.

Doug recounts his experience defending RBP companies from lawsuits and saw the evolution from uniform level reimbursement to variation depending on the market.

“Ultimately, the reason these facilities were coming after the RBP companies is it’s a market threat…you’re now a price maker, instead of a price taker.”

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Sarah Hostetter on how market consolidation affects independent physician practices

Sarah Hostetter, Managing Director, Physician and Ambulatory Research at Advisory Board speaks with Suzanne about the landscape of physician practices. Whats happening with acquisition of physician practices?  Are there any independent practices left?  Why do some physicians choose to join larger practices? Sarah digs into the data and sheds light on how the changing landscape affects physicians themselves, but also the market at large.

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Massachusetts Slams the Breaks on Mass General’s Expansion Plans: Insights into the Value of State Health Policy Commissions

The State of Massachusetts made headlines when its Health Policy Commission (HPC) launched what the press called “a double-barreled attack” on Mass General Brigham’s expansion plans. In the first of its one-two punches, the HPC concluded that Mass General’s $2.3B plan was “not consistent with the Commonwealth’s goals for cost containment.” 

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All I Want for Health Care in 2022…

December is a time for reflection: both on the year that passed, and on the year to come.  December is also a time for giving – regardless of one’s faith or lack thereof.  This got us thinking at CPR: if we could give one gift to the American health care system in 2022, what would it be, and what can we at CPR do to make our wish-list a reality in the year to come?

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