What’s on CPR’s shared agenda for 2018?

January 23, 2018

CPR has always believed that if those who buy health care align their demands and send consistent signals to the market, they can change the system. Becoming a CPR member signifies a purchaser’s understanding and commitment to a “shared agenda” – one that outlines how the group should exert their collective influence to tackle the most challenging areas of health care.

We started out in 2010 by focusing on changing provider payment but quickly realized our shared agenda would encompass much more.  We have created a rallying cry for price and quality transparency.  We have worked to standardize which quality measures purchasers demand from health plans and providers.  We have helped purchasers navigate special topics like telehealth, specialty pharmacy, maternity care, ACO performance, and behavioral health.

Today, we are 32 member organizations strong.  Though our dedication to improving the system using the power of the purchaser remains, each year what we need to push for changes as the system evolves.

So what are the top priorities for CPR’s shared agenda for 2018?

  1. More rigorous evaluations of payment reforms, delivery reforms and benefit designs. Health care leaders have championed the transition to value-based payment methods to correct the inefficiencies of fee-for-service and produce a more affordable, higher quality health care system. There has been a flurry of effort to implement more and more value-oriented payment. But what is lacking are objective and rigorous evaluations of whether these new approaches to payments are producing more affordable, higher quality care.  We need to demand careful evaluations so purchasers can understand which reforms lead to higher-value health care and are worth the investment.  We are calling all willing parties to work with us to build the evidence base!
  1. More meaningful, comprehensive reporting by health plans on the performance of their payment and delivery reform programs. Employers and other health care purchasers have had a hard time getting the full story about the results of their health plans’ efforts to reform provider payment and care delivery. Many employers find that health plan reports display very few measures of performance and typically only positive results – metrics where performance is strong or improving. As health plans invest in more value-oriented payment and delivery reform programs, purchasers need greater transparency into whether these programs are working and how they are impacting their populations.  Only then can purchasers develop more effective strategies in partnership with their plans.  We have started a campaign for widespread use by purchasers of our Standard Plan ACO Report.  Join in!
  1. Correcting the physician fee schedule. The vast majority of alternative payment methods in use today simply layer incentives on top of traditional fee-for-service. Those added incentives won’t change the fact that the fee amounts themselves are flawed – both Medicare and commercial payments over-value some services and pay too much for them (e.g., interpreting the results of an electrocardiogram), and undervalue other services and pay too little for them (e.g., visits with patients to diagnose and treat depression). We will be seeking willing payer partners to work on corrections so that our efforts to pay differently aren’t built upon a broken chassis.
  1. Maternity care payment and delivery reform. Maternity care, particularly labor and delivery services, are not at the level of performance where they need to be in this country. In fact, the maternal mortality rate has been rising!  We have far too much intervention in labor and delivery resulting in added expense and worse outcomes for mothers and babies.  Despite the fact that maternity care reform has long been on our shared agenda, we must keep pushing until health plans and providers put policies and practices in place that adhere to clinical guidelines. CPR and our members will keep pushing for advancements in maternity care until we see meaningful improvements.

To learn more about CPR’s shared agenda, why these areas are of great importance, and which tools employers and purchasers can use to hold their partners accountable, visit our Shared Agenda page.

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