Catalyst for Payment Reform

payment reform

You too can be a health care Catalyst.

Like any 501c3 nonprofit (and many organizations for that matter), CPR must remain nimble.  We recently setup the capability to accept tax-deductible contributions to fund our important work.  You can also get involved with CPR. For example, you can become a member, participate in our enterprise subscription program, collaborate with us on research or thought leadership.  Know that regardless of how you contribute, your support is going to a small, but mighty organization tackling health care’s biggest challenges on behalf of employer-purchasers.

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CPR’s REFs Updated with Equity

At CPR, we have a saying: if you don’t have a REF, you can’t trust the scoreboard. That’s why CPR created “Reform Evaluation Frameworks,” or – affectionately – REFs. 

REFs are program evaluation tools that compel plan administrators and point solution vendors to use a standardized methodology and standardized set of performance indicators to measure cost savings, clinical quality and utilization.

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Is Payment Reform Exiting a 2+Year Shelter-in-Place?

The pandemic stimulated significant uncertainty about the future of payment reform. After all, payment reform is a disruptive strategy, requiring providers to modify practice patterns and payers to negotiate measures of performance by which providers are held accountable for care quality. The early days of the pandemic were a time during which pushing payers and providers on payment reform could have been viewed as being out of touch with the magnitude of the situation. The pandemic created a pause and stimulated leaders to rethink the potential of payment reform. For example, we pondered whether hybrid capitation/fee-for-service would gain momentum as a means for primary care providers to receive guaranteed revenue.  And we continue to ponder it, because frankly, our $4+ trillion health care system doesn’t turn on a dime. CPR has been and remains in the

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Karen Sepucha on shared decision making

Suzanne calls up Karen Sepucha, PhD, director of the Health Decision Sciences Center in the General Medicine Division at Massachusetts General Hospital and an associate professor in Medicine at Harvard Medical School to discuss shared decision making.

So what do the data say? Well, they confirm a lot of what employer-purchasers are feeling at the moment.

“We’re seeing just about the fastest rate of health care inflation in our data ever.”

What’s a solution? Price Transparency Data.

We have all of this price transparency data, what are we going to do with it?

Well, we need a new model if we’re going to get consumers to use it. We have to get to them upstream, we have to make it really simple, and we have to change the incentives so that they save thousands of dollars by getting with the program.

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Nick Reber on Doctor Quality Analytics

Suzanne calls up Nick Reber, CEO and Founder of Garner Health to talk price transparency, analytics, and quality.

So what do the data say? Well, they confirm a lot of what employer-purchasers are feeling at the moment.

“We’re seeing just about the fastest rate of health care inflation in our data ever.”

What’s a solution? Price Transparency Data.

We have all of this price transparency data, what are we going to do with it?

Well, we need a new model if we’re going to get consumers to use it. We have to get to them upstream, we have to make it really simple, and we have to change the incentives so that they save thousands of dollars by getting with the program.

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Bob Galvin revisits the state of payment reform

Suzanne calls up Bob Galvin, CMO of Blackstone and chairman of CPR’s board of directors, to follow up on their previous discussion on the state of payment reform. So where are we at? Progress is slow, yet steady — we’ve had rain delays, changing pitchers, changing managers, but the game isn’t over.

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Featured Experts who have advised our Members

Being a member of CPR is about so much more than being a leading national voice in the fight for more access, equity, and quality in health care. It’s about being a part of a team who band together to strategically push the health care system. How do members achieve this? CPR creates the space where members can engage with experts, health plans, and CPR staff to incubate trailblazing health care strategy.

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Dr. Jeff Wells speaks about advanced primary care and Marathon Health

Suzanne calls up Dr. Jeff Wells, CEO and co-founder of Marathon Health to talk about advanced primary care models and how it fits in with onsite and near-site clinic, and virtual care.

Suzanne and Jeff dive into the term advanced primary care and how it differs from prior terminology used to describe high-value primary care strategies. In addition, they discuss why there is a lack of primary care providers compared to most other developed countries and what the future looks like for primary care.

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Peter Lee on the last twenty years in health care reform

Suzanne calls up Peter Lee, the former Executive Director of Covered California to talk about the last twenty years in health care reform. He explains how many of the payment reforms executed in the commercial space have really been on the margins, and many employees are spending more for worse care than ever before.

So what’s the problem? Lack of real alignment on measures, and not enough dollars at play at the right level. “We focused a lot on provider level payment…not at the health plans. Health care is a team sport, if we aren’t making the quarterback of the team, the health plans, accountable for quality and value, nothing is going to happen.”

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