Apr 18, 2019
“Those who say it cannot be done are usually interrupted by others doing it.” That’s a James Baldwin quote to keep in mind while considering employers ginning up real change in the health care industry.
Generally speaking, employers who still don’t believe they could have an impact helping their employees get better health care at lower prices, don’t listen to this podcast. But if they did, I’d suggest this James Baldwin quote is apropos.
It’s probably also apropos for providers, carriers, Pharma … anyone who isn’t paying a whole lot of attention to the success of organizations like Catalyst for Payment Reform. Americans, meaning employees, can no longer afford their health care. Deductibles are higher than savings, basically meaning that employees have health plans they can’t even afford to use; and it costs as much as a midsize sedan—a new one every single year. Furthermore, we have employer health care spend chewing up raises. Employers and their CFOs are increasingly in a position where they have to act. It’s no longer an option.
I speak today with Suzanne Delbanco, PhD, executive director of Catalyst for Payment Reform. In one of her past lives, Suzanne was the founding CEO of The Leapfrog Group.
Suzanne Delbanco, PhD, is
the executive director of Catalyst for Payment Reform (CPR), an
independent, nonprofit corporation working to catalyze employers,
public purchasers, and others to implement strategies that produce
higher-value health care and improve the functioning of the health
care marketplace. In addition to her duties at CPR, Suzanne serves
on the advisory board of The Source on Healthcare Price &
Competition at the University of California–Hastings and the Blue
Cross Blue Shield Institute. Previously, she was the founding CEO
of The Leapfrog Group. Suzanne holds a PhD in public policy from
the Goldman School of Public Policy and an MPH from the School of
Public Health at the University of
02:25 The moment when Suzanne’s colleagues realized Leapfrog was
03:58 Suzanne’s work at Catalyst for Payment Reform vs Leapfrog.
06:48 EP217 with Steve Watson—price points of hospitals and how the data evade us.
08:11 “At the end of the day, it’s very difficult to know if you’re getting good value if you don’t know what you’re paying.”
09:48 “The balance of power varies from market to market and has been changing over time.”
12:00 How employers can ban together to reduce their health care costs.
13:33 Price transparency.
16:04 Elevating the best practice.
16:51 A surprising contract point that everyone needs.
17:30 Getting rid of gag clauses.
19:26 “There’s never going to be 1 solution.”
19:38 Payment reform and what we mean by that.
20:42 Shared savings, shared risk, and bundled payments.
23:06 Today’s tipping point.
24:29 Trading choice for affordability.
26:43 Controlling costs 2 ways.
26:59 “Even if employers were … to … create a narrower network, not necessarily narrow, there’d be huge savings to be had.”
27:16 The limited sight of narrow networks.
27:36 Getting to a narrow network of high-quality, low-cost providers.
30:30 Suzanne’s advice for health care executives.
31:55 “Be prepared to demonstrate value, because employers [will] be asking.”