Value-Oriented Payment Reform

    • February 28, 2015

Dates of Project: November 15, 2012 through April 14, 2014

Description: The Catalyst for Payment Reform (CPR) project team led its membership of 34 large health care purchasers in refining and strengthening a shared agenda for payment reform. The group also engaged health plans in acting on health payment reforms and made initial steps toward designing a pilot embodying specific reforms.

“I think the collective pressure we have put on the plans....has been a decisive factor in that change.”—Suzanne Delbanco, Executive Director, Catalyst for Payment Reform

Key Results

    • According to the CPR’s 2014 National Scorecard on Payment Reform (funded by the Commonwealth Fund and California HealthCare Foundation), 40 percent of the payments designed by the health plans it worked with aimed to encourage health care providers to deliver higher-quality and, in some cases, more affordable care—a 29 point increase over figures reported in 2013.
  • The project team refined and strengthened its shared purchaser agenda on payment reform—chiefly through toolkits and how-to guides—in three areas:

    • Promoting price transparency as a building block for payment reform
    • Promoting reforms to maternity care payment
    • Assessing the utility of reference pricing in enhancing the value of provider payments
  • The team and the member organizations engaged health plans in payment reform through meetings and webinars.

  • The team began work on designing a pilot focused on innovative payment designs for hip and knee replacement.