Press Release: New Health Care Market Assessment for Denver Finds Providers have Market Power, but Market is at Tipping Point as Employers Act

DENVER, CO – September 12, 2019 – Catalyst for Payment Reform (CPR) and the Colorado Business Group on Health (CBGH) today released a new study that examines the dynamics underlying and shaping the Denver area’s health care marketplace and identifies which purchasing and payment reform strategies have the best chance of success given the market characteristics.

The Denver-area Market Assessment Report finds that health care providers in Denver – both hospital systems and physician groups – have significant market power but employer-purchasers and health plans, supported by previous and recently passed legislation, are well-positioned to change the dynamic and work toward specific reforms.

“Health care costs, primarily driven by high prices and seemingly unwarranted increases, are edging out salary growth and economic development,” said Bob Smith, MBA, executive director of CBGH. “These trends are taking a toll on every employer from school districts to manufacturers and are simply not sustainable. This new, independent, data-driven report, in which stakeholders had direct input, gives purchasers the tools to make changes to our current health care system.”

The report summarizes findings from an analysis of data about the structure of the Denver health care marketplace, an online survey of a mix of 22 stakeholders seeking their perspectives, and primary interviews with 11 key informants.

“CPR created its Market Assessment methodology to determine, for any specific geographic health care marketplace, the dynamics among providers, health plans and purchasers and to use that information to identify payment and other reform strategies that can work with that dynamic,” said Suzanne Delbanco, PhD, executive director, CPR. “Employers and other health care purchasers can now use CPR’s assessment of Denver to move forward the conversation and reform the market.”

CPR’s analysis yielded six recommendations that purchasers can use to advance payment reform in Denver:

1. Continue building on purchaser momentum, particularly in concert with the statewide purchaser cooperative initiative.
2. Implement benefit designs to encourage consumers seek higher value care.
3. Align with Medicaid in two-sided risk arrangements and the Polis-Primavera “Roadmap to Affordability.”
4. Implement value-oriented programs such as two-sided risk arrangements that hold providers accountable to quality and cost targets.
5. Expand on earlier success in enhancing transparency on health care quality and prices.
6. Promote the benchmarking of prices relative to Medicare as a means for allowing employers to determine whether the health care prices they are paying are reasonable.

“Four of the six recommendations substantially align with those put forth by the Commission on Affordable Health Care in 2017,” said Smith. “It’s time to put these recommendations into action. Colorado legislators have provided the tools and this administration is providing the support. Employers now have the responsibility to act.”

Bill Lindsay, principal of Lindsay 3, LLC consulting, and former co-chair of the Commission on Affordable Health Care will present the Denver-area Market Assessment findings at CBGH’s September 12 Strategy Session. To learn more and register, visit: www.cbghealth.org.

About Catalyst for Payment Reform

Catalyst for Payment Reform is an independent, non-profit organization working on behalf of large employers and other health care purchasers to catalyze employers, public purchasers and others to implement strategies that produce higher-value health care and improve the functioning of the health care marketplace. For a list of CPR members, click here. For more information visit: www.catalyze.org and follow us on LinkedIn and Twitter.  This report was supported by a grant made by the Peterson Center on Healthcare.

About Colorado Business Group on Health

CBGH is a purchaser-led, multi-stakeholder non-profit coalition committed to collaboratively improving the health care value-proposition for all Coloradans and their communities. Since 1996, CBGH has worked on initiatives designed to restructure health care delivery and improve quality and costs. For additional information visit: cbghealth.org and follow us on Twitter and LinkedIn.