News - Catalyst for Payment Reform

Massachusetts Slams the Breaks on Mass General’s Expansion Plans: Insights into the Value of State Health Policy Commissions

February 7, 2022

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.”

Alexandra Drane on Supporting Caregivers as Critical Care Partners

January 27, 2022

Suzanne Delbanco speaks with Alexandra Drane, Co-Founder & CEO of ARCHANGELS, diving into the critical role of caregivers and why they must be part of the clinical care team. She also discusses how ARCHANGELS’ Caregiver Intensity Index (CII) is designed to engage caregivers and help them see themselves in the role.

THE TOP 10 PODCASTS OF 2021

December 27, 2021

December is wrapping up and the New Year is right around the corner. But just before looking ahead to 2022, CPR is taking one last look back at 2021. We’re highlighting the Top 10 podcasts and featured experts of this year. These insights are definitely worth revisiting (and remembering in the year to come!).

Jo Porter Gives Suzanne the Scoop on All Things APCD

December 20, 2021

Suzanne and Jo discuss the recent growth in APCDs across the country, renewed federal interest in APCDs, how states are collecting and sharing the information in their APCDs, and data barriers. Suzanne and Jo also discuss the benefits of APCD data for employers and other health care purchasers looking to create high-value benefits and health care programs for members.

All I Want for Health Care in 2022…

December 14, 2021

December is a time for reflection: both on the year that passed, and on the year to come. December is also a time for giving – regardless of one’s faith or lack thereof. This got us thinking at CPR: if we could give one gift to the American health care system in 2022, what would it be, and what can we at CPR do to make our wish-list a reality in the year to come?

Enhanced telehealth and behavioral health access: rays of light in the eye of the storm?

November 30, 2021

In a prior blog article on the 2021 KFF Employer Health Benefits Survey, we noted that employers are in the eye of a hurricane and will have to confront some painful tradeoffs when costs spiral again. But the significant exceptions to employers’ “wait and see approach” to health care benefits during the first year of the COVID-19 pandemic are in the areas of telehealth and behavioral health, including at the intersection of the two.

KFF 2021 Employee Benefits Survey: Welcome to the Eye of the Hurricane

November 16, 2021

KFF released results from its 2021 survey on trends in employer health benefits. The topline takeaway: not much has changed. Employers appear committed to maintaining the status quo, with a few key adaptations that speak to the necessities of managing health care benefits during a pandemic. In 2021, employers are in the eye of a hurricane, but what comes next?

CPR’s Health Plan User Groups: An Antidote to the Dog and Pony Show

October 25, 2021

Purchasers: how many times have you attended a meeting with your health plan that focused solely on high-level concepts and success stories, but not a meaningful, tactical conversation about the issues of greatest concern to you? CPR’s Health Plan User Groups (HPUGs) are like a client advisory group meeting, but turned upside down: the clients, not the health plans, set the agenda, offering a forum for a substantive and rich two-way dialogue.

Unlocking the Power of the All Payer Claims Database – Use Cases from Colorado

October 18, 2021

Colorado passed legislation authorizing the creation of its APCD in 2010. Today, the database houses over 718 million medical, dental and pharmacy claims from 44 payers (including 35 commercial plans). What makes Colorado’s APCD so powerful, however, is its pairing with the publicly-facing reporting and analysis that CIVHC provides.

Katy Spangler on what employers need to know about federal price transparency regulations

October 4, 2021

Suzanne Delbanco speaks with Katy Spangler, Principal at Spangler Strategies, about recent federal activity on health care price transparency and what employers need to know moving forward.

The Action is on the Field, Not the Sideline

September 28, 2021

Employers and other health care purchasers – it’s time to step off of the sidelines and onto the field. Across CPR’s membership and broader audience, there has never been more innovation and agency among health care purchasers than there is today.

Erin Fuse Brown, JD, MPH, on what employers need to know about surprise billing legislation

September 28, 2021

Suzanne Delbanco connects with Erin Fuse Brown to discuss the No Surprises Act and what employers should be paying attention to with regards to surprise billing protections.

Three Provisions to Give Your 2022 ASO Agreement Extra Spice

September 20, 2021

CPR published a collective set of demands that purchasers should include in their ASO agreements. When multiple purchasers ask for the same thing at the same time, it broadcasts a powerful signal to TPAs on purchaser priorities. Among these aspirational yet foundational expectations, the delivery is in the details. Here are three provisions of note in CPR’s latest model contract language.

Niall Brennan answers tough questions on the price and utilization data behind health care cost growth for employers

September 20, 2021

Suzanne Delbanco catches up with Niall Brennan, President and CEO of the Health Care Cost Institute (HCCI), to ask the tough questions on price and utilization data for employer-sponsored health care.

Dr. Irene Dankwa-Mullan on why every employer needs a health equity strategy

September 14, 2021

Dr. Irene Dankwa-Mullan highlights the need for employers and their business associates – including TPAs, consultants, and other partners – to acknowledge that health inequities exist and use their role as plan sponsors and benefits administrators to address them through comprehensive, data-driven, health equity strategies.

Are there surprises with the implementation of the No Surprises Act?

September 13, 2021

Getting these details right will determine if implementation of the No Surprises Act will not only protect patients from most high and unexpected medical costs but also help reduce the need for balance billing in the first place and keep prices in check.

Understanding the Bioethics Behind Employer Vaccine Mandates for COVID-19

September 7, 2021

Should employers impose COVID-19 vaccine mandates? The keyword here is “should” (“can” is a legal question that has already been largely answered and is not the subject of this blog). But “should vaccination be required” leaves room for debate. While bioethical analyses typically rely on multiple frameworks, this blog should be considered a primer on two of the ‘hallmark’ bioethical principles: autonomy and justice.

Jason Richmond on how C-Suite leaders should address employee mental health needs

August 31, 2021

Suzanne Delbanco speaks with Jason Richmond, Head of Consultant Relations at Ginger, a digital mental health care provider. Jason Richmond explores the supply and demand imbalance between mental health patients

Got hospital “lemons” in your network? Ditch them or make lemon-“aid”?

August 24, 2021

Back in October 2019, we published a blog post on the challenges of building a high-performance network (HPN). We landed on the conclusion that an HPN should be designed with sensitivity to

Michelle Zettergren on direct contracting, COEs, and employer compliance with new ERISA regulations

August 17, 2021

“What’s great about [direct contracting] relationships is they allow for an employer to work directly with a health system in developing a solution that’s specific to their employee base. They can design programs that address their specific needs, such as addressing diabetes issues within their employee population or behavioral health. In return, the health system expects employers to develop benefit plans and contribution strategies that steer their employees to that health system.”

Glen Tullman on Wayfinding with AI

Paul Grady on the Power of Purchaser Activation

Tackling the Healthcare Access Crisis with Ashok Subramanian

Dr. Matthew Resnick on the state of quality measurement

Rachael Jones and Emily Walker on Value-Based Contracting: It’s not magic, it’s math.