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Can surprise billing happen to you?
Last week, we told you about a $4,999 surprise bill. I didn’t have a $4,999 surprise, but it was close. At 30 years old, I had a tonsillectomy. I was enrolled in an HMO product, and my hospital, ENT...
View ArticleTrent Haywood on BCBSA’s role in addressing community barriers to health
Listen in as Trent Haywood, MD, JD, Senior Vice President and Chief Medical Officer of the Blue Cross Blue Shield Association, outlines key initiatives and goals for addressing social determinants of...
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You can’t build a network by casting a net
Unpacking the complexity of high-performance network design The National Business Group on Health (NBGH) predicted that by 2018 a staggering 61% of employers would offer narrow or high-performance...
View ArticleCheryl DeMars on achieving longevity in group health care purchasing
Listen in as Suzanne Delbanco calls Cheryl DeMars, President & CEO of The Alliance – a cooperative of 240 self-funded employers pooling their purchasing power to control costs and improve quality....
View ArticleBrooks Daverman on Tennessee Medicaid’s bundled payment success
Listen in to Brooks Daverman, Deputy Director of TennCare (Tennessee’s Medicaid program), debate Catalyst for Payment Reform’s Suzanne Delbanco on the need for standard bundled payment definitions....
View ArticleMark Fendrick on unveiling a cost-neutral Value-Based Insurance Design option
Listen in as Mark Fendrick, Director of the University of Michigan Center for Value-Based Insurance Design and a practicing general internist, provides an overview of the new developments in the world...
View ArticleTricia McGinnis on how Medicaid MCOs approach Social Determinants of Health
How and why are social determinants of health programs making their way into the Medicaid managed care realm? To find out, Suzanne Delbanco calls Tricia McGinnis, MPP, MPH, Executive Vice President...
View ArticleFinding value with CPR’s Data Warehouse & Analytics Evaluation project
Data warehouse and analytics vendors are important partners for the employers and other health care purchasers who self-fund health care coverage for their employees and their dependents. A data...
View ArticleChapin White on the Employer Hospital Price Transparency Project
Price transparency is not one-size-fits-all. The optimal price information for a patient is different from the price transparency a physician would find useful and different, too, from what an...
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Got hospital “lemons” in your network? Ditch them or make lemon-“aid”?
A few weeks ago, 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 local market...
View ArticleRobert Smith on how a purchaser alliance can change Denver’s market dynamics
Robert Smith, Executive Director of the Colorado Business Group (CBGH) on Health, checks in with Suzanne Delbanco on what’s new in Colorado’s capitol since CPR and CBGH released the Denver-Area Market...
View ArticleWill Medicaid Managed Care States invent next-gen payment reform?
At present, 39 states plus the District of Columbia contract with managed care organizations (MCOs) to provide care for some or all of their Medicaid enrollees. MCOS are private plans that receive...
View ArticlePositive results from TennCare’s Innovative Payment and Delivery Reform Programs
When the health care payment reform movement began, the first thing CPR saw was an uptick in pay for performance. Payers had some experience with providing bonuses to health care providers that meet...
View ArticleCPR’s Top 10 Podcasts of all time
CPR is grateful for both our amazing Listening In (with Permission) guests and audience. Since CPR launched the podcast in the spring of 2017, Suzanne Delbanco has recorded over 80 episodes with...
View ArticleBeth Waldman on the ins and outs of Medicaid managed care
Listen in as CPR’s Director of Projects & Research, Julianne McGarry, checks in with Beth Waldman, JD, MPH, Senior Consultant with Bailit Health. Beth Waldman is one of the leading experts in...
View ArticleEmily Chen of MediQuire on using data in direct contracting arrangements
CPR’s Program Director, Andréa Caballero, calls up MediQuire’s CEO, Emily Chen, to learn why purchasers are choosing to directly contract with providers in order to improve the value of their health...
View ArticleCelebrate the holidays with CPR’s Free Downloads
CPR’s mission is to help employers and other health care purchasers get better value for their health care dollar. While we provide the bulk of our resources to employers and health care purchasers...
View Article2020: CPR’s Agenda to Reform the Health Care Marketplace for...
This is going to be quite a year. At CPR we’ve fastened our seatbelts for full speed. The core of what we do remains the same: we are pushing for effective payment reform, effective purchasers and a...
View ArticleMythbuster: Direct contracting will never become a real trend.
The health care marketplace continues to evolve, as health care organizations consolidate and experiment with new value-oriented models. As these new strategies emerge to drive high-value purchasing,...
View ArticleA Blueprint for Action
In the commercial market, health plans negotiate rates on behalf of health care purchasers; they use purchasers’ collective volume to command better value for our health care dollars – or that’s how...
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