Catalyst for Payment Reform

value based payment

Glen Tullman on Wayfinding with AI

On this episode Ryan calls Glen Tullman, CEO of Transcarent, to discuss the untapped power of generative AI in revolutionizing healthcare accessibility and affordability. Glen describes the concept of “wayfinding”,

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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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