Between health plans, health care providers, and employer-purchasers- who holds the market-shaping power in Central Florida?

Tampa- and Orlando-based employers are less than a two-hour drive from one another, but are their abilities to push for higher-value health care similar?

How does the state’s legislative and regulatory landscape affect health care purchasers’ ability to catalyze change?

These are some of the questions explored in CPR’s Advancing Payment Reform in Florida Report, completed in partnership with the Florida Alliance for Healthcare Value. Using CPR’s proprietary Market Assessment Tool (MAT), CPR categorized the health care marketplace dynamics in the Tampa and Orlando regions, developing tailored recommendations for purchasers interested in implementing payment reform programs.

The Advancing Payment Reform in Florida Report provides a data-driven understanding of the two markets to identify the most promising ways for purchasers to improve health care value moving forward. Similar to previous market assessments, Catalyst for Payment Reform serves as an independent third-party to help the various stakeholders, who will ultimately need to work together to implement change, understand the local market dynamics and what possibilities are most viable. All health care is local, and payment reform options that may work well in some markets may actually produce unintended negative consequences in others.

The report is structured into four sections:

1. A cross-cutting overview the Tampa and Orlando health care markets.
2. A 360-degree analysis of the three stakeholder groups that most shape payment reform opportunities in each market, with a section highlighting opportunities in behavioral health.
3. An overview of the varying market types in existence and how the two markets fit into CPR’s typology.
4. A specific list of reform opportunities based on the market dynamics in Tampa and Orlando, public-private partnership opportunities, and legislative conditions, with statewide implications.

The report summarizes findings from CPR’s multi-pronged Market Assessment Methodology. CPR conducted a structural analysis of the Tampa and Orlando health care marketplaces, fielded an online survey capturing insights from a mix of 34 stakeholders, and held primary interviews with 11 key informants. CPR added survey and interview questions to understand how COVID-19 may impact topics such as stakeholder engagement, payment reform, and balance of power.

CPR’s analysis yielded four recommendations that purchasers can use to advance payment reform in Tampa and Orlando:

1. Build on purchaser momentum by drawing upon the state statute offering purchasers technical and strategic assistance with health care cost-containment strategies.
2. Stay active in policy forums to ensure a more functional marketplace.
3. Urge providers to move from upside-only payment reforms to downside risk arrangements that hold them accountable for meeting quality and cost targets.
4. Implement benefit designs to encourage consumers to seek higher value care.

While CPR’s assessment focused on the Tampa and Orlando markets, the findings have implications for efforts to advance paying for value across the state of Florida.

This report was completed in partnership with the Florida Alliance for Healthcare Value