In this episode of Listening In (With Permission), Ryan calls Chris Chan, Chief Value Officer of finHealth, to discuss the pitfalls many self-insured employers face related to their claims review
In this episode of Listening In (With Permission) Dr. Matthew Resnick, Chief Medical Officer at Embold Health, discusses with Ryan the evolution of quality measurement and improvement in healthcare, emphasizing
In this podcast episode Dayne and Tim Huke, Chief Growth Officer for Cedar Gate Technologies, explore firsthand the core of CPR’s latest case study, Unlocking Value: Diabetes Care Management Vendors’
$935 billion. It’s hard to imagine what that number really means. It’s approximately the amount the United States spends on Medicare, it exceeds our national military spending, and it’s more than what
32BJ Health Fund | New York’s pricey hospitals draw pushback from labor Aon | U.S. Employers Eye Provider Networks Amid Looming Medical Cost Pressures, Aon Reports CalPERS | CA VBID Program Boosted Primary
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.
Suzanne calls up Candace Shaffer, Senior Director, Benefits at Purdue University to discuss the benefits purchasing strategies that she and her team have implemented and some of the tremendous savings as a result of those strategies.
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
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.
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.
Suzanne calls Kelsey Brykman, Senior Program Officer at the Center for Health Care Strategies to talk about the intersection of primary care and health equity.
Suzanne calls Kelsey Brykman, Senior Program Officer at the Center for Health Care Strategies to talk about the intersection of primary care and health equity.
Suzanne calls Kelsey Brykman, Senior Program Officer at the Center for Health Care Strategies to talk about the intersection of primary care and health equity.
New Morgan Health-NORC analysis reveals important insights about the largest source of health insurance coverage in the U.S. — employer-sponsored insurance. The study is a snapshot of health outcomes and
Suzanne calls Rachael Jones, Senior Vice President, Performance Analytics & Quality at Cotiviti, to discuss health equity and what employers and other health care purchasers can do to advance it.
32BJ Health Fund | 32BJ Health Fund releases report and analysis on hospital prices Aon | Aon tool quantifies impact of social determinants of health Arizona Health Care Cost Containment
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.
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.
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.
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.”
