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In the latest episode of Listening In (With Permission), we dive deep into the challenges and potential solutions around high healthcare costs that employers face in states like Florida, Michigan, and Nevada. This conversation brings together Karen van Caulil, Bret Jackson, and Chris Syverson to discuss findings from CPR's recent research, reflecti…
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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", which integrates benefits navigation, clinical guidance, and care delivery into a seamless user experience using generative AI as the co…
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In this episode, Ryan Olmsted from Catalyst for Payment Reform (CPR) sits down with Paul Grady, Principal at Alera Group to discuss the critical role of purchaser activation in mitigating rising costs in healthcare and improving value.Paul and Ryan also delve into the importance of purchasers' involvement in policy-making and how their participatio…
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Tune into our latest episode of Listening In (With Permission) as Ashok Subramanian, CEO and founder of Centivo, and Ryan Olmstead dive deep into the critical issues of healthcare affordability and access. Discover groundbreaking insights from Centivo's recent guide, "Breaking Down and Breaking Through the Healthcare Affordability and Access Crisis…
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Ryan calls Chris Chan, Chief Value Officer of finHealth, to discuss the pitfalls many self-insured employers face related to their claims review as they try to meet their fiduciary responsibilities."We're seeing increased scrutiny and requests from employers to say, “Hey, we, we know we have this cycle in the past that we worked where we just autom…
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In this episode of Listening In (With Permission) Dr. Matthew Resnick, Chief Medical Officer at Embold Health, discusses with Ryan the evolution of quality measurement and improvement in healthcare, emphasizing the importance of aligning care with evidence-based guidelines. He highlights the need for integrating quality and cost considerations to d…
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In this podcast episode Dayne and Tim Huke, Chief Growth Officer for Cedar Gate Technologies, explore firsthand the core of CPR's latest case study, Unlocking Value: Diabetes Care Management Vendors' Impact on Quality and Clinical Outcomes for Self-Funded Employers. What are the challenges faced by employers as they navigate the expansive ocean of …
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On our latest podcast episode the tagline is, "Value-Based Contracting: It's Not Magic, It's Math." 🏥 Andréa Caballero calls the co-founding team at Syntax Health, Rachael Jones, Chief Executive Officer, and Emily Walker, Chief Analytics Officer, to demystify the complexities of value-based contracting, and encourage employers to stop treating it a…
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In our latest episode of Listening In (With Permission), Guy calls Rob Andrews, founding CEO of the Health Transformation Alliance (HTA) and former U.S. Congressperson.Listen in as Rob and Guy discuss the challenges and triumphs in healthcare, and how the HTA is bridging the gap between providers and patients, bringing about a new era of convenienc…
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Part two of our three-part data series.In this insightful podcast episode, we dive deep into the evolving role of Chief Financial Officers (CFOs) in healthcare purchasing. Join Ryan Olmstead, CPR's Director of Member Services and Jeffrey Hogan, President of Upside Health Advisors, as they discuss the significant changes brought about by the Consoli…
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Part Three of our three-part Data Podcast Series.In this episode of Listening In (With Permission), CPR's Director of Member Services, Ryan Olmstead engages in a captivating conversation with Julie Selesnick, Senior Counsel at Berger Montague, with two decades of experience in healthcare law. Together, they delve into the complex world of healthcar…
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"So when I say it's a gift, anytime a consumer gets enough information to make an informed decision, it's a gift."Listen In (With Permission) to Hugh O'Toole, CEO of Innovu, about the transformation happening in employer-sponsored healthcare. Hugh explains how data transparency is the key to making informed decisions and achieving significant cost …
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Suzanne calls up Candace Shaffer, Senior Director, Benefits at Purdue University to discuss the benefits purchasing strategies that she and her team have implemented and some of the tremendous savings as a result of those strategies. They also discuss what goes into thorough strategic decision making; utilizing your data, understanding your busines…
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Andréa call Allison Sesso, President and CEO of RIP Medical Debt (RIP) to discuss the crisis of Medical Debt and RIP's unique mitigation strategy. They also discuss innovative policy on the state and federal level to help relieve consumers of medicals debt and make health care more affordable."While we love our solution and we think it's really imp…
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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. This podcast is spons…
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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."Ultimat…
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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…
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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 bo…
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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!…
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Suzanne calls up Karen Sepucha, PhD, director of the Health Decision Sciences Center in the General Medicine Division at Massachusetts General Hospital and an associate professor in Medicine at Harvard Medical School to discuss shared decision making. Shared decision making is "really focused on the physicians and the doctors and health care team b…
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Suzanne calls up Nick Reber, CEO and Founder of Garner Health to talk price transparency, analytics, and quality. 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…
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Suzanne calls Jen Porto, Manager of Leader Education at Headspace Health to discuss strategies on developing a culture of mental wellness at work. Jen and her team launched a leadership education program to equip managers with science-backed practices to drive cultural change in organizations, support mental health and well-being in the workplace a…
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Suzanne calls up Dr. Doug Salvador, Chief Quality Officer at Bay State Health and Board Member of the Society to Improve Diagnosis in Medicine (SIDM). Suzanne and Doug discuss the prevalence of diagnosis errors, steps to take to learn from them, and how to prevent them in the future."You need to have some experts, in your organization in diagnosis …
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Suzanne calls up Thi Montalvo, VP, Analytics and Reporting at Transcarent, and Elodie Olsen, Senior Director North America Health Analytics Practice Leader at WTW to talk about wrestling data away from certain health plans, the reasons behind the proliferation of point solutions, and sometimes sneaky trend guarantees.…
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Suzanne calls Kelsey Brykman, Senior Program Officer at the Center for Health Care Strategies to talk about the intersection of primary care and health equity.Kelsey describes her work under the Promoting Health Equity through Primary Care Innovation in Medicaid Managed Care Project, working with a variety of state Medicaid agencies Kelsey and her …
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Suzanne calls Rachael Jones, Senior Vice President, Performance Analytics & Quality at Cotiviti, to discuss health equity and what employers and other health care purchasers can do to advance it."You really have to have a comprehensive strategy that looks at clinical data, financial data, member stratification, gaps in care..."​"Beyond having that …
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Suzanne calls up Bob Galvin, CMO of Blackstone and chairman of CPR's board of directors, to follow up on their previous discussion on the state of payment reform. So where are we at? Progress is slow, yet steady -- we've had rain delays, changing pitchers, changing managers, but the game isn't over."It's hard getting through, inning by inning when …
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Suzanne calls up Aneesh Chopra, Co-Founder and President of CareJourney, to talk about the current state of health care transparency policy and how the US is faring. So, what’s the mood on current regulations and government oversight? “The general feeling in the field is one of skepticism,” says Chopra, but he’s much more bullish on it. According t…
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Suzanne calls Alice Hm Chen, Chief Medical Officer at Covered California, and asks about her work in quality measurement and health equity.As the nation's largest state-based health insurance exchange, how is Covered California thinking about its responsibility to deliver equitable care to its member population?"I think a key thing for everyone to …
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Suzanne calls up Dr. Jeff Wells, CEO and co-founder of Marathon Health to talk about advanced primary care models and how it fits in with onsite and near-site clinic, and virtual care. Suzanne and Jeff dive into the term advanced primary care and how it differs from prior terminology used to describe high-value primary care strategies. In addition,…
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Suzanne calls up Peter Lee, the former Executive Director of Covered California to talk about the last twenty years in health care reform. He explains how many of the payment reforms executed in the commercial space have really been on the margins, and many employees are spending more for worse care than ever before.So what's the problem? Lack of r…
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Suzanne Delbanco speaks with Roslyn (Roz) Murray, a doctoral candidate at The University of Michigan School of Public Health and former Catalyst for Payment Reform Employee. Roz delves into her first peer-reviewed paper in Health Affairs, which concludes that the evidence on commercial value-based payment models is mixed. Suzanne and Roz dive into …
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“80% of providers believe that the unpaid caregiver should have a seat at table, but only 20% believe they actually do.”Suzanne Delbanco speaks with Alexandra Drane, Co-Founder & CEO of ARCHANGELS, diving into the critical role of caregivers and why they must be part of the clinical care team.She also discusses how ARCHANGELS’ Caregiver Intensity I…
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Suzanne Delbanco speaks with Dr. Irene Dankwa-Mullan, Chief Health Equity Officer at IBM Watson Health and Deputy Chief Health Officer within the Center for AI, Research & Evaluation. As an industry physician and scientist working at the intersection of AI, health equity, and health care, Dr. Dankwa-Mullan speaks to best practices for employers int…
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Suzanne Delbanco speaks with Jason Richmond, Head of Consultant Relations at Ginger, a digital mental health care provider.Jason Richmond explores the supply demand imbalance between mental health patients and providers in the United States right now, and why the traditional provider network model to access care doesn’t carry over well into the men…
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Suzanne Delbanco speaks with Michelle Zettergren, President of Labor and Public Sector markets and Chief Sales and Marketing Officer for Brighton Health Plan Solutions, a health enablement company that serves as third-party administrator to self-funded employers and other health care purchasers. Michelle heads marketing, customer retention, and bus…
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Suzanne Delbanco speaks with Scott Doolittle, CFO of Quantum Health, a health care navigation company providing care coordination and navigation support. Scott oversees Quantum Health’s business intelligence units, where he leads a team that validates the company’s actuarial results. Scott Doolittle provides insights into how Quantum Health engages…
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Suzanne Delbanco consults Bob Berenson, MD, Institute Fellow at the Urban Institute, on what's going on with telehealth payment policy in both Medicare and the commercial sector and why employers should be paying attention. In May 2021, Bob Berenson testified at the Senate Finance Committee, where he laid out the reasons why fee-for-service is a no…
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Suzanne Delbanco speaks with Nate Freese, MBA, Senior Director of Data Strategy at Grand Rounds Health, a health care quality and navigation solution offering employers a data-driven clinical navigation platform paired with patient advocacy tools. Nate leads data strategy at Grand Rounds Health, where his team is responsible for building algorithms…
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Suzanne Delbanco talks with David Vivero, CEO and Co-Founder of Amino Health, a health care financial wellness solution that combines data, design, and consumer-first thinking to curate personalized recommendations for specific care needs. Prior to Amino, David was VP of Rentals at Zillow, a consumer internet company that has transformed the home a…
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Suzanne calls Patrick Tigue, the Health Insurance Commissioner for the State of Rhode Island, to discuss the Office of the Health Insurance Commissioner (OHIC)'s initiatives to stem health care cost growth in RI.Rhode Island has established a cost growth benchmarking process to bring greater transparency to the market. They've also created a first-…
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Suzanne Delbanco talks with Thi Montalvo, Health Analytics Practice Leader – Health and Benefits for Willis Towers Watson. In her role, Thi helps employers and other health care purchasers make data-driven decisions for their health benefits strategy. While she’s seen many successful use-cases over her nine years specializing in health analytics, s…
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Suzanne Delbanco calls CJ Stimson, MD, the Senior Vice President of Value Transformation at Vanderbilt University Medical Center (VUMC), to discuss Vanderbilt’s direct contract bundled payment arrangement for maternity care with Metro Nashville Public Schools (MNPS). This call serves as follow-up to the webinar hosted by CPR in March 2021, where Dr…
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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…
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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…
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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…
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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.…
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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…
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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…
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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…
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