Catalyst for 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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Allison Sesso on the Crisis of Medical Debt

Andréa calls Dr. Vikas Saini, President of the LOWN Institute to discuss their Hospital Index which measures a hospital’s social responsibility, examining how hospitals rank in terms of health outcomes, value and equity. The index is comprised of 53 different metrics, Dr. Saini explains how they collect and analyze their data.

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Vikas Saini on The Lown Institute’s Hospital Index

Andréa calls Dr. Vikas Saini, President of the LOWN Institute to discuss their Hospital Index which measures a hospital’s social responsibility, examining how hospitals rank in terms of health outcomes, value and equity. The index is comprised of 53 different metrics, Dr. Saini explains how they collect and analyze their data.

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2023 Health Plan User Groups: No dog and pony shows allowed

Granted, most HPUG meetings veer more toward “engaged conversation” than “heated debate” but this is how CPR moves the Overton Window.  CPR members don’t just ask health plans for updates on how many dollars they’ve dedicated to their bundled payment program: we push them to respond to tough questions in new territory like data sharing, health equity and their post-COVID payment reform strategies.  We make them all take the same test through our program evaluation tools so they can’t cherry-pick statistics or hide behind shiny marketing materials.  And because CPR members set the agenda for the HPUG meetings, the discussions focus on what matters most to you, purchasers, and what keeps you up at night.  It’s OK if the health plans squirm a little; it’s what helps them grow.

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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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