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Suzanne Delbanco chats with Nathan Counts, a seasoned health benefits professional who recently joined Amtrak as Head of Total Rewards. Previously, Nathan was Assistant Vice President – Global Benefits for a leading telecommunications company, where he actively participated in CPR membership activities, helping shape CPR’s Shared Purchaser Agenda b…
 
Julianne McGarry catches up with Christopher Whaley, PhD, Policy Researcher at RAND Corporation and one of the lead authors of the RAND's Hospital Price Transparency Study. The study, spearheaded by the Employer's Forum of Indiana, has revealed price variation within and across health care markets by re-pricing hospital and outpatient services as a…
 
CPR’s Program Director, Andréa Caballero, chats with Stephen Furia, Senior Vice President, Population Health at Mount Sinai Health System, one of the largest health systems in New York with 3,000 physicians, 400 locations, and a world renown medical school. The Population Health division is the business unit within Mount Sinai that works directly w…
 
Andréa Caballero, MPA, speaks with Linda Schwimmer, JD, President and CEO of the New Jersey Health Care Quality Institute (Quality Institute) to learn about a pressing issue: the health of New Jersey’s Small Group Insurance Market. This market, which covers employers with 2-50 employees in the Garden State, is on the precipice of a downward spiral.…
 
Suzanne Delbanco chats with Rick Abbott, VP of Product and Market Solutions at Premera Blue Cross. Premera Blue Cross is a health plan in the Pacific Northwest, serving about 2.2 million members with customers ranging from large tech companies to family-owned grocery stores.Suzanne and Rick discuss if narrow networks, also known as high-performance…
 
Suzanne Delbanco connects with Chris Cigarran, CEO of Imagine Health, an alternative health plan offering curated provider networks in select markets across the country. Prior to Imagine Health, Chris built the employer and government sales division of a wellness company and has also served as Chief HR Officer.To begin the interview, Suzanne lays o…
 
Suzanne Delbanco interviews Ashok Subramanian, CEO and Founder of Centivo Health, an alternative Third-Party Administrator (TPA) that emphasizes value-based direct contracting and utilization of high-quality providers. Prior to Centivo, Ashok founded Liazon, a private benefits exchange acquired in 2013 by Willis Towers Watson. Suzanne and Ashok exp…
 
Listen in as Suzanne Delbanco connects with Alan Muney, MD, MHA, former Chief Medical Officer of Cigna, former CEO of Equity Healthcare, and current health care advisor to multiple venture equity firms. Suzanne asks Alan a fundamental question: how can employers counterbalance the high and rising prices of health care providers? His answer: look at…
 
Listen in as Suzanne Delbanco chats with Anna Sinaiko, PhD, Assistant Professor at the Harvard T. H. Chan School of Public Health. Anna Sinaiko studies patient or individual decision making in health care settings, often referred to as consumerism in health care. She and her colleagues are currently wrapping up a synthesis of evidence from the last…
 
Suzanne speaks with Peter Lee, Executive Director of Covered California Health Exchange, to discover how Covered California looks to accelerate positive change in the health care system. Peter Lee and his team at Covered California are preparing the contract language for the next phase of work with the 11 insurance carriers that participate in the …
 
Listen in as Suzanne dials up Bob Galvin, MD, Operating Partner of Equity Healthcare and former Executive Director of Health Services and Chief Medical Officer for General Electric. As one of CPR’s founders, Bob Galvin knows that employer-purchasers have the power to demand better value from the health system; the question is, how should employer-p…
 
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 to joining NASHP, Marilyn served as administrator of the Health Care and Benefits Division for Montana’s state employee health plan. There, she led the succes…
 
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 care dollars. They discuss what makes a good match between purchasers and health systems seeking to work together, and what challenges self-funded empl…
 
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 Medicaid delivery system and payment reform design, having served as the Director of Medicaid for the Commonwealth of Massachusetts from 2003-2007 and consulti…
 
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 employer-purchaser needs in order to play it's role in the health care ecosystem. Suzanne Delbanco calls Chapin White, PhD, Adjunct Senior Policy Researcher …
 
How and why are social determinants of health making its way into the Medicaid managed care realm? To find out, Suzanne Delbanco calls Tricia McGinnis, MPP, MPH, Executive Vice President and Chief Program Officer of the Center for Health Care Strategies. The Center's December 2018 report, "Addressing Social Determinants of Health via Medicaid Manag…
 
Listen in as Mark Fendrick, Director of the University of Michigan Center for Value-Based Insurance Design and a practicing general internist, catches Suzanne Delbanco up on the new developments in the world of Value-Based Insurance Design (VBID). After years of bipartisan support and tireless advocacy, the federal government has made important cha…
 
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 and how to scale the payment method nationwide. Brooks Daverman has helped lead the implementation of 48 different episodes-of-care with over 2,000 differ…
 
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. The Alliance contracts directly with health care systems to provide health care for over 90K employees and their families in Wisconsin, Iowa, and Illinoi…
 
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 health, also referred to as addressing social risk factors or community barriers. Learn more about BCBSA's innovative partnerships, either nationally …
 
Suzanne Delbanco chats with Frank Opelka, MD, FACS, Medical Director for Quality and Health Policy with the American College of Surgeons, to understand how surgeons across the United States view bundled or episode-based payment. Frank describes the questions and concerns surgeons hold about moving away from fee-for-service payments, as well as the …
 
Suzanne Delbanco calls Rachel Brodie, Director of the Performance Information programs at Pacific Business Group on Health (PBGH) to discuss patient-reported outcomes (PROs). Listen in to learn how PROs work and why employers are paying attention to this new area of quality measurement.By Catalyst for Payment Reform
 
Listen in to Kaveh Safavi, MD, JD, Senior Managing Director, Head of Global Health Practice at Accenture, as he discusses recent research on the associated costs of the United State's health care system's complexity with Catalyst for Payment Reform's Suzanne Delbanco. There are so many confusing terms when it comes to accessing health insurance cov…
 
Suzanne Delbanco catches up with Sam Arsenault, Director of National Treatment Quality Initiatives for Shatterproof, on the latest milestones in the work to bring provider quality ratings into the substance use disorder space. Sam goes over the dimensions that the provider quality ratings will cover, piloting the effort in five states, and how prov…
 
Listen in as Ateev Mehrotra, MD, MPH, Associate Professor of health care policy and medicine at Harvard Medical School and a hospitalist at Beth Israel Deaconess Medical Center, chats all things convenient care with Suzanne Delbanco. Between retails clinics, onsite clinics, and telemedicine, there are many new options cropping up for consumers. Wha…
 
Listen in as Suzanne Delbanco chats with Gloria Sachdev, PharmD, President and CEO of the Employers’ Forum of Indiana. They discuss one of the hottest studies in health care: the RAND Hospital Prices In Indiana study published by Chapin White. The landmark employer-led study uses claims data from self-insured employers to report hospital prices by …
 
Listen in as CPR's Executive Director, Suzanne Delbanco, chats with Google's Healthcare Delivery Benefits Manager, Rob Paczkowski. Just like the HR department of many employers, the benefits team at Google works hard to build awareness among Googlers about in-network, high-value health care options, including telemedicine, on-site clinics, and even…
 
Suzanne Delbanco chats with Jeffrey Davis, MD, MPH, Senior Health Management Consultant with Willis Towers Watson, about a rapidly expanding area of intrigue for employers: genetic testing. He breaks down the types of genetic testing out there, as well as concrete steps employers can take to navigate this space. Listen in to find out if and when ge…
 
Suzanne Delbanco calls up Lisa Woods, Senior Director of Health Care Benefits at Walmart Stores Inc., to discuss Walmart’s efforts to control costs and deliver high-value health care using a Center of Excellence approach. Suzanne and Lisa catch up about Walmart’s COE strategy for spinal surgery, why Walmart initially began the program, and how thes…
 
Suzanne Delbanco checks in with Mike Stull, Chief Marketing Officer at Employers Health Coalition, to talk all things pharmacy. Listen in as Suzanne and Mike discuss what employers and health care purchasers can do to stay afloat amid rising pharmacy costs, the role of the pharmacy benefit managers now and in the future, and much more.…
 
Suzanne Delbanco, CPR's Executive Director, checks in with Debbie Welle-Powell, Chief Population Health Officer at Essentia Health, an integrated health system in the Midwest. Debbie and Suzanne discuss the definition of accountable care organizations (ACOs), how ACOs can impact the quality and cost of health care, patient experience in an ACO and …
 
Suzanne Delbanco dials up Emily Transue, MD, Associate Medical Director for Clinical Quality and Care Transformation at the Washington State Health Care Authority (HCA), to chat about HCA's shared decision making strategy and the results so far. Learn what shared decision making is, why HCA introduced shared decision making, how HCA is using shared…
 
Suzanne Delbanco dials up Ann Greiner, President and CEO of the Patient Centered Primary Care Collaborative (PCPCC), to discuss the patient centered medical home model. Ann shares where the PCMH came from, how the concept and use has evolved over time, how the PCMH can influence health care delivery, and the evidence on PCMHs so far.…
 
Suzanne Delbanco checks in with David Schleifer, Ph.D.,Vice President and Director of Research at Public Agenda, a nonpartisan, nonprofit research and public engagement organization that works to strengthen democracy and expand opportunity in America by fostering thoughtful public opinion, meaningful public participation and responsive public insti…
 
Suzanne calls Frederick Isasi, Executive Director of Families USA, to understand the aspects of today’s health care insurance landscape that are putting the greatest strain on families. They discuss prescription drug costs and solutions, the comeback of short term and association health plans, and how health care purchasers share the same concerns …
 
Suzanne Delbanco calls Mai Pham, MD, Vice President of Provider Alignment Solutions at Anthem Inc., and former Chief Innovation Officer at CMMI, to discuss the Medicare Physician Fee Schedule. They explore the history of the fee schedule, its repercussions across the entire health care marketplace, and what Anthem plans to do - in the long haul- to…
 
Suzanne dials up her "guru" on provider payment- Bob Berenson of the Urban Institute. Bob draws on his 20 years experience as an internal medicine doctor, before moving to policy work with CMS and MedPAC, to answer Suzanne's questions about the prevalence of mis- and missed- diagnoses in health care, as well as other root causes of the estimated $7…
 
Andréa Caballero speaks with David Muhlestein, Chief Research Officer at Leavitt Partners, about his latest research titled "Growth of Population-Based Payments is Not Associated With a Decrease in Market-Level Cost Growth, Yet." They discuss what really dictates good competition within a health care market, how much revenue is necessary to make a …
 
Suzanne Delbanco calls Peter Kilmartin, Consultant Effectiveness Leader and US Leadership Team at Mercer Health & Benefits, to discuss the four areas where employers can build out their health care purchasing strategy. With the Vitals For Change Scorecard, co-developed by Mercer and CPR, employers can benchmark their benefits purchasing strategy ag…
 
Did you know that 40% of Americans struggle to come up with $400 to cover an emergency? This reality helps contextualize the very real decisions low-wage workers face as they decide to seek health care services, especially if they have a high-deductible. Suzanne discusses this issue with Jeff Levin-Scherz, National Co-Leader of Willis Towers Watson…
 
What if people with substance use disorder could have a one-stop-shop for finding high-quality treatment options? Suzanne Delbanco checks in with Sam Arsenault, Director of National Treatment Quality Initiatives at Shatteproof on their provider rating system to tackle that very issue. Substance abuse is a critical health care area full of misconcep…
 
Suzanne 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 employee-sponsored health care. If you're interested in understanding what is driving health care costs and using data to figure out the best ways to curtail spending growth, then this episo…
 
Suzanne dials John Bass, Founder and CEO of Hashed Health, who shares his insights on how and why blockchain can reduce costs, create trust, and improve competition in health care. Listen in as he breaks down what blockchain is and how, as a data infrastructure, it can reduce friction in different health care value chains like bundled payment and p…
 
CPR's senior project and research manager, Roz Murray, calls Jaime King, Associate Dean and Faculty Director of the UCSF/UC Hastings Consortium on Science, Law and Health Policy, to learn about current state activity to address rising pharmacy prices. State Medicaid agencies are proposing different solutions like closed formularies and capping annu…
 
Suzanne speaks with Malini Nijagal, MD, MPH, of UCSF to learn what motivated her new call to action in the American Journal of Obstetrics & Gynecology, which outlines how maternity care providers can prepare for the shift to value-based payment. Malini also shares how episode-based payments can unlock higher-quality maternity care and even help add…
 
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