Catalyst for Payment Reform

Remembering Suzanne Delbanco

2024 was a difficult year for our CPR community. In May our beloved founding executive director, Suzanne Delbanco, lost her four-year battle with cancer. Her family, the CPR staff, and

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Glen Tullman on Wayfinding with AI

On this episode Ryan calls Glen Tullman, CEO of Transcarent, to discuss the untapped power of generative AI in revolutionizing healthcare accessibility and affordability. Glen describes the concept of “wayfinding”,

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Allison Sesso on the Crisis of Medical Debt

Andréa calls Dr. Vikas Saini, President of the LOWN Institute to discuss their Hospital Index which measures a hospital’s social responsibility, examining how hospitals rank in terms of health outcomes, value and equity. The index is comprised of 53 different metrics, Dr. Saini explains how they collect and analyze their data.

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Vikas Saini on The Lown Institute’s Hospital Index

Andréa calls Dr. Vikas Saini, President of the LOWN Institute to discuss their Hospital Index which measures a hospital’s social responsibility, examining how hospitals rank in terms of health outcomes, value and equity. The index is comprised of 53 different metrics, Dr. Saini explains how they collect and analyze their data.

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Doug Aldeen takes a deep dive into Reference-based Pricing

Julianne calls up Doug Aldeen, ESQ an ERISA Healthcare Attorney and General Counsel to discuss the Reference Based Pricing (RBP) landscape, specifically how RBP has evolved over time.

Doug recounts his experience defending RBP companies from lawsuits and saw the evolution from uniform level reimbursement to variation depending on the market.

“Ultimately, the reason these facilities were coming after the RBP companies is it’s a market threat…you’re now a price maker, instead of a price taker.”

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Sarah Hostetter on how market consolidation affects independent physician practices

Sarah Hostetter, Managing Director, Physician and Ambulatory Research at Advisory Board speaks with Suzanne about the landscape of physician practices. Whats happening with acquisition of physician practices?  Are there any independent practices left?  Why do some physicians choose to join larger practices? Sarah digs into the data and sheds light on how the changing landscape affects physicians themselves, but also the market at large.

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Gloria Sachdev on Sage Transparency

Suzanne calls up Gloria Sachdev to discuss the Employer’s Forum of Indiana’s (EFI) latest tool, Sage Transparency. Sage Transparency is a tool that brings together public and proprietary data on hospital pricing and quality. It gives users access to price and quality data for thousands of hospitals across the United States—and it’s free!

So what do the data say? Well, they confirm a lot of what employer-purchasers are feeling at the moment.

“We’re seeing just about the fastest rate of health care inflation in our data ever.”

What’s a solution? Price Transparency Data.

We have all of this price transparency data, what are we going to do with it?

Well, we need a new model if we’re going to get consumers to use it. We have to get to them upstream, we have to make it really simple, and we have to change the incentives so that they save thousands of dollars by getting with the program.

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Marilyn Bartlett on NASHP’s Hospital Cost Tool

Suzanne speaks to Marilyn Bartlett about the National Academy for State Health Policy’s (NASHP) Hospital Cost Tool and her role in creating it. NASHP’s interactive Hospital Cost Tool provides anyone from policymakers to researchers with insights into how much hospitals spend on patient care services. The tool also shows how those costs relate to both the hospital charges (list prices) and the actual prices paid by health plans.

So what do the data say? Well, they confirm a lot of what employer-purchasers are feeling at the moment.

“We’re seeing just about the fastest rate of health care inflation in our data ever.”

What’s a solution? Price Transparency Data.

We have all of this price transparency data, what are we going to do with it?

Well, we need a new model if we’re going to get consumers to use it. We have to get to them upstream, we have to make it really simple, and we have to change the incentives so that they save thousands of dollars by getting with the program.

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