Listening In (With Permission): Conversations About Today's Pressing Health Care Topics

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 consulting for a multitude of states and other stakeholder...

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 at the RAND Corporation to learn about the innovat...

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 Managed Care Contracts and Section 1115 Demonstrations,...

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 changes to Medicare Advantage and private health plan...

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 different provider organizations, from small rural pract...

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 Illinois. Find out why the Alliance was formed in the ear...

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 with Lyft for transportation services or locally w...

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 benefits to bundled payments from a surgeon's poin...

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.

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 coverage: deductibles, co-pays, in-network, etc. What...

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 providers are reacting to the initiative. Listen in to...

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. What do employers need to know about quality and cost...

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 health system relative to Medicare. Tune in to fin...

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 home health care. Listen in to hear about the inn...

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 genetic testing is more than just a "shiny new objec...

Episode 61: George Schwartz on the Benefits of Palliative Care for Patients and Caregivers by Catalyst for Payment Reform

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 these efforts have helped to reduce inappropriate care...

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 the importance of incorporating risk. Listen in an...

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 decision making in tandem with its' Accountable C...

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 institutions. They discuss the perspectives of America...

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 as individual patients. Frederick, who helped writ...

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 diverge from the status-quo for the sake of impro...

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 $750 billion spent on unnecessary or inappropriate c...