$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
Before the pandemic, the use of telemedicine was steadily increasing as a care modality, but still faced regulatory, payment, and logistical challenges that hindered its widespread adoption. But when the world shut
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.
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.
on is a massive wave fueled by provider consolidation, increased expenses, and pent-up demand for services (resulting in higher utilization), and it appears ready to break over the industry, bringing with it higher health care prices and [even more] unfavorable market dynamics for employer-purchasers and health plans. Against this wall of provider market power, purchasers may feel powerless with no way to protect themselves but there are both preventive actions and countermeasures they can take to mitigate the impact.
younger daughter Dylan was three, she emphatically declared that she hated swimming lessons. Unfortunately for her, she has a mother (me) who believes with equal conviction that learning to swim is a safety issue and therefore non-negotiable. Thus, Dylan and I were at an impasse, except that one of us (me) believed that she could convince the other (Dylan) to relent through a combination of authority and influence (and also bribery). One afternoon at our local pool, I found myself pleading, cajoling, promising sweets and screen time (and threatening their removal), if Dylan would just allow me to help her into her bathing suit. “You don’t even have to go in the water!” I lied. Dylan didn’t buy it and was expressing her mistrust in a 9-alarm screaming toddler melt-down. It was at that moment that another woman – likely old enough to have grown children of her own – paused and offered the following counsel: whatever you’re trying to do, she said, it isn’t working.
As an independent, nonprofit organization with the mission 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, we pride ourselves on our being forward thinking and agile. So, it’s no surprise that we make a list of New Year’s resolutions every year. This year, we share it with you.
n the one dozen years since CPR began, we have tackled a number of big issues in health care, pushing for effective payment reform, helping to launch the price transparency movement, and sounding the alarm on growing provider market power, among others.
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
Will telehealth help save health care from unsustainable cost growth and inequities in outcomes? Or will it do the opposite?
Stakeholders across the health care industry are currently drafting their telehealth roadmaps for the future. Virtual-first health plan products are popping up. Providers are figuring out how much of their patient care will continue to stay virtual post-pandemic and studying best practices to effectively engage diverse patients. At the federal level, Congress introduced the CONNECT for Health Act of 2021, which seeks to codify telehealth provisions made during the public health emergency permanently into Medicare. The time is now for health care purchasers – including states – to demand telehealth programs and policies with two clear goals in mind:
Be financially sustainable for those who use and pay for it
Be implemented so that everyone has a fair and just opportunity to benefit
Suzanne Delbanco consults Bob Berenson, MD, Institute Fellow at the Urban Institute, on what’s going on with telehealth payment policy in both Medicare and the commercial sector and why employers
When the RBP vendor and provider “agree” on a rate, who pays the difference? The RBP vendor or the employer? It depends – and the outcome will likely be reflected in the vendor’s administrative fee.
Suzanne Delbanco catches up with CJ Stimson, MD, JD, the Senior Vice President of Value Transformation at Vanderbilt University Medical Center (VUMC), to discuss Vanderbilt’s direct contract bundled payment arrangement for maternity care with Metro Nashville Public Schools (MNPS).
A tornado is what comes to mind when thinking about the future of alternative payment models (APMs). It’s not because the health care ecosystem (let alone APMs) are poised to wreak horrific destruction upon us all. Rather, the tornado analogy derives from the powerful and influential forces blowing the APM movement in multiple and conflicting directions.
When the health care payment reform movement began, the first thing CPR saw was an uptick in pay for performance. Because payers had some experience with providing bonuses to health
The economic downturn has only heightened the need for Colorado employers to implement high-value health care purchasing strategies. This is challenging due to Colorado’s market dynamics. We decided to revisit the recommendations in CPR’s Denver-Area Market Assessment Report to explore how Colorado can overcome the stalemate with large health systems.
U.S. employers are hungry for new approaches to managing health care costs and improving quality. The average annual premium for employer-sponsored family health coverage surpassed $20,000 in 2019, and annual increases remain
What we’ve learned from health care economists, policy experts, and business leaders has begun to illuminate the contours of a new health care economy, re-shaped in the wake of the global pandemic.
Recorded on February 28, 2020. Listen in as Suzanne Delbanco speaks with Marilyn Bartlett, CPA, CMA, CFM, Senior Policy Fellow with the National Academy for State Health Policy (NASHP). Prior
Suzanne calls Michael Chernew, PhD, director of the Healthcare Markets and Regulation (HMR) Lab in the Department of Health Care Policy at Harvard Medical School. They discuss his December 2019 publication in
