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

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 care each year.

He previews part of his presentation for CPR's upcoming Virtual Summit by exploring the Institute of Medicine's report on this critical area that is top of mind for many employer-purchasers. https://www.urban.org/research/publication/doing-better-doing-less-approaches-tackle-overuse-services

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 business case for reforming a delivery system, and what kinds of evaluations are needed to scale and inform the next generation of payment reform programs.

Link to report: https://leavittpartners.com/whitepaper/growth-of-population-based-payments-is-not-associated-with-a-decrease-in-market-level-cost-growth-yet/

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 against their peers based on how they are 1) paying for value, 2) driving to quality, 3) personalizing the experience, and 4) embracing disruption. Peter shares anecdotes from the field, including how some CEO's are now viewing disruption with a positive connotation in their quest to improve the health care experience and outcomes of their employees.

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’s Health Management Practice, and Assistant Professor at Harvard School of Public Health. He has a wealth of insight into what employers should think about as they design benefits for low-wage workers.

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 misconceptions, stigma, and low-quality providers forgoing evidence-based guidelines. Learn about Shatteproof's strategy for systemic change and how employers can benefit from their programs.

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 episode is for you!

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 provider credentialing. If you're hearing about blockchain and want to know what it means for health care purchasers, this episode is for you!

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 annual drug spending. Listen in to hear what Jaime thinks about the merits of these policies.

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 address our nation's maternal mortality crisis among African-American women.

Suzanne speaks with Larry Becker, former Director of Strategic Partnerships and Alliances for Xerox Corporation, and Jean Slutsky, Chief Engagement and Dissemination Officer at the Patient-Centered Outcomes Research Institute (PCORI), to hear about the organization's research and what it means for employers and others in the health care industry.