Navigating Payment Reform for Providers, Payers, and Pharma

Harvard Business School, Boston, Massachusetts
November 02, 2017
1:00pm-5:00pm ET

True payment reform will require three of the main stakeholders in U.S. health care — providers, payers, and pharmaceutical makers — to collaborate and innovate. NEJM Catalyst gathered expert leaders, researchers, and physicians from these key players for a free Web event, Navigating Payment Reform for Providers, Payers, and Pharma, broadcast live from Harvard Business School.

Payment reform is essential to health care delivery transformation. Progress in payment reform requires cooperation between providers, payers, and pharmaceutical makers. How these stakeholders drive payment reform, how they respond to it, and the complex interplay among them will determine whether health care costs can be successfully addressed or become ever more expensive.

In this free live Web event, Navigating Payment Reform for Providers, Payers, and Pharma, NEJM Catalyst convened key players to share their views and to challenge one another during three separate sessions. Each session included interactive audience Q&A.

This event, hosted by Harvard Business School and HBS Health Care Initiative, was led by Leemore Dafny, PhD, HBS Professor of Business Administration and NEJM Catalyst Theme Leader for the New Marketplace theme.

Watch insightful presentations, real-world case studies, and an interactive Q&A session with our industry-leading experts.

You will learn:

  • The benefits of collaborating to rein in skyrocketing drug pricing and why risk-based agreements between pharmaceutical makers and hospitals might be the future.
  • Why it’s time to stop tweaking the health care delivery system and instead take on the risk required to bring about real change.
  • How payers must come off the sidelines and learn to innovate and negotiate a real path to change, complete with targeted incentives.

View the archive.




Welcome and Introduction

Namita Mohta, MD, Clinical Editor, NEJM Catalyst; Center for Healthcare Delivery Sciences, Brigham and Women’s Hospital


Opening Talk

Leemore Dafny, Bruce V. Rauner Professor of Business Administration at Harvard Business School, NEJM Catalyst New Marketplace Theme Leader and Event Host

It’s nothing more than Econ 101: you get what you pay for. Three key subsectors of the U.S. health care ecosystem — providers, payers, and pharmaceuticals — have been heavily shaped by the economic incentives facing them. Changing these sectors requires changing payment approaches, which is precisely what change agents in all three sectors are attempting to do. What do we know, what don’t we know, and where is payment reform likely to yield substantial payoffs?


Session 1: Collaborating to Rein in Pharma Pricing

Drug prices are skyrocketing, not only for new products but also for generics. Market-based solutions don’t seem to be working. How should provider and payer organizations respond to, and collaborate with, pharmaceutical companies? Are risk-based agreements between pharma companies and health systems the future? This session features a leading health care researcher, a payer’s chief medical officer responsible for pharmaceutical contracts, and a physician-researcher specializing in pharmacoeconomics.


Amitabh Chandra, PhD, Malcolm Wiener Professor of Social Policy and Director of Health Policy Research, Harvard Kennedy School of Government

Michael Sherman, MD, MBA, Senior Vice President and Chief Medical Officer, Harvard Pilgrim Health Care


Aaron Kesselheim, MD, Associate Professor of Medicine, Harvard Medical School




Session 2: Providers Taking Real Risk to Realize Change

For all the talk in recent years of health care reform and value-based payment, provider organizations haven’t actually changed much. Fee-for-service payment remains predominant. Truly taking risk requires deep change in care delivery. Tweaking the same old delivery system simply defers change. In this session, a leading health care policy analyst and the founder of an innovative primary care clinic will speak, moderated by the faculty chair of the HBS Health Care Initiative.


Michael McWilliams, MD, PhD, Warren Alpert Associate Professor of Health Care Policy, Harvard Medical School; General Internist, Brigham and Women’s Hospital

Griffin Myers, MD, MBA, Co-founder and Chief Medical Officer, Oak Street Health


Robert Huckman, PhD, Albert J. Weatherhead III Professor of Business Administration Chair, Harvard Business School




Session 3: How Payers are Negotiating a New Path for Transformation

Are private payers developing innovative collaborations with providers and implementing payment reforms, or are they free-riding on public-sector initiatives? In this session, leaders from a payer and the segment’s key customers — employers — will assess the performance of the payer sector, and discuss how payers and employers can drive deeper change.


David Lansky, PhD, President & CEO, Pacific Business Group on Health

Bob Galvin, MD, MBA, CEO, Equity Healthcare

Lynn Garbee, MBA, Senior Director of Reimbursement and Collaborative Care, Cigna HealthCare


Leemore Dafny, Bruce V. Rauner Professor of Business Administration at Harvard Business School, NEJM Catalyst New Marketplace Theme Leader and Event Host


Closing Remarks

Leemore Dafny, NEJM Catalyst New Marketplace Theme Leader and Event Host

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