In this episode of Listening In (With Permission), Andréa connects with Kristof Stremikis, Director, Market Analysis and Insights at the California Healthcare Foundation, for a candid exploration of Medicaid’s evolving landscape and its surprising relevance to the employer-sponsored insurance market.
Episode 142: Beyond Pie Charts: Mike Hanlon on Real-Time Data, Carve Outs, and Employer Power by Catalyst for Payment Reform
In this episode of Listening In (With Permission), Ryan Olmstead sits down with Mike Hanlon, founder and CEO of Abbet, to unpack some of the boldest ideas in health benefits management—and why they might not be so radical after all. Hanlon, whose company builds automation tools for large employer plan sponsors, offers a candid look at why traditional approaches to benefits data and cost management have failed to move the needle, and what it will take to finally deliver better outcomes at lower c...
In this episode of Listening In (With Permission), Shawn Gremminger, President and CEO of the National Alliance of Healthcare Purchaser Coalitions, joins Andréa Caballero of Catalyst for Payment Reform to dive into a pressing but often overlooked issue: the impact of the 340B Drug Pricing Program on pharmacy costs for employers and healthcare purchasers. The 340B program, originally intended to support safety-net hospitals and community health centers, has expanded drastically over the years. To...
In this episode of LIWP's Healthcare Highway, Ryan Olmstead of Catalyst for Payment Reform speaks with Kendra Gipson, Director, Vendor Services & Contracts at State of Tennessee. Kendra oversees health plans for over 300,000 employees, and in this engaging conversation, she delves into the impact of recent pharmacy and PBM (Pharmacy Benefit Manager) bills being considered at the Tennessee State House. Kendra provides an insightful overview of two pivotal bills making their way through the le...
Patricia Kelmar, Senior Healthcare Campaigns Director for USPIRG, sits down with Andrea Caballero from Catalyst for Payment Reform to discuss one of the most pressing issues in healthcare affordability: facility fees. These hidden charges are adding significant costs to medical bills, even for routine visits and telehealth appointments. With her extensive background in patient safety and healthcare advocacy, Patricia shares her insights on how these fees are becoming more widespread and the poli...
Episode 138: Hospital Consolidation Across Geographic Markets with Katie Gudiksen and Brent Fulton by Catalyst for Payment Reform
In this inaugural episode of the Healthcare Highway, CPR's limited podcast series, Ryan Olmstead sits down with Misha Sharp, the Assistant Director of Policy at the 32BJ Health Fund, to explore the Fund's innovative approaches to tackling health care costs. In the episode Misha delves into the Fund’s active role in shaping health care policy, including its involvement in New York’s Fair Pricing Act and efforts to promote price transparency in hospital services. She also highlights 32BJ’s innovat...
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, reflecting on state-specific struggles and opportunities for policy intervention. They explore the implications of soaring insurance premiums—like the 16.9% i...
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 conductor. This new take on traditional "navigation" models could be poised to significantly disrupt the norm, consolidating fragmented services into a...
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 participation in committees like the Connecticut Cost Growth Benchmark Advisory Board is essential for addressing healthcare cost increases. Paul shares real-lif...
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," which highlights the alarming statistic that 43% of working Americans earning under $50,000 regularly skip necessary care due to cost. Ashok and Ry...
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 automatically approve these things, but we need to be better stewards of our plan and really understand on a weekly basis whether the charges are appropri...
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 drive progress in the healthcare system and addresses the disparities in access to high-quality care, particularly in rural areas, and suggests short-t...
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 point solution vendors, seeking answers to the ever-growing health care cost dilemma? Find out in this podcast episode!
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 as a sideshow, and instead to make it the main event. Rachael and Emily break down the math behind value-based contracting and share anecdotes from th...
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 convenience and trust in primary care. Listen to how HTA, through their advanced primary care program, is knitting together a network of primary care doctors a...
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 Consolidated Appropriations Act of 2021 (CAA). The conversation delves into how, under the CAA, CFOs are now named fiduciaries, personally liable for procur...
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 healthcare data transparency, legal challenges, and the evolving policy landscape. Julie shares her impressive background, having transitioned from a defense ...
"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 savings, and how the new CAA regulation will help free up the data necessary to simplify an overly-complex system. This is part one of a three part s...
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 business, and seeking regular input from plan members are all steps Candace and her team take to plan strategically, and based on the results, very effective...
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 important to help resolve the issue for individuals right now...we very clearly understand and appreciate that we are not the answer, which is why we do...
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 sponsored by Embold Health.
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. "Ultimately, the reason these facilities were coming after the RBP companies is it's a market threat...you're now a price maker, instead of a price taker."...
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 how the changing landscape affects physicians themselves, but also the market at large.
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 both the hospital charges (list prices) and the actual prices paid by health plans.
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!
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 bringing in what [they] know about the clinical evidence...having that doctors expertise [applied] to this patient sitting in front of them and also br...
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 have all of this price transparency data, what are we going to do with it? Well, we need a new model if we're going to get consumers to use it. We h...
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 and improve employee engagement, productivity and retention.
