Catalyst for Payment Reform

MARKET POWER

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.” 

Read More

Reference-based pricing: 3 models that cut health care cost inflation at its roots

Employers and consumers are eager for solutions that attack health care cost inflation at its root cause. One prominent strategy is using reference-based pricing (RBP) models that anchor commercial rates to Medicare, or some other rationalized external benchmark.  Like so many health care innovations, reference-based frameworks encompass multiple branching models, and as such the term “RBP” has come to mean different things to different stakeholders. 

Read More

What Xavier Becerra’s nomination as HHS Secretary could mean for employer-purchasers

During the economic recovery, we need competitive health care markets as a counterweight against health care price inflation.  With the economy struggling, employers and other health care purchasers have less money than ever to spend on health care and need every tool at their disposal to keep expenses under control.  Employers across the country will be watching to see if the Sutter case will serve as a warning to other dominant providers, or if anticompetitive behavior will be given a COVID hall pass. As Secretary of Health and Human Services, Becerra’s understanding of these dynamics will inevitably shape his work on health care delivery and payment reforms, policies regarding transparency of price and quality information, and much more. 

Read More

Alan Muney, MD, on why large health plans have a total cost of care advantage

Listen in as Suzanne Delbanco connects with Alan Muney, MD, MHA, former Chief Medical Officer of Cigna, former CEO of Equity Healthcare, and current health care advisor to multiple venture equity firms. This interview is part of CPR’s current work to understand whether group purchasing efforts can secure better health care value for employer-purchasers.

Read More