The Framework Already Exists. The Question is Whether Anyone Will Use It.
Peter Hayes, retired president and CEO of the Healthcare Purchaser Alliance of Maine, former benefits director at Hannaford Supermarkets, and two-time gubernatorial appointee to Maine’s Health Care Reform Commission, joined the CLEARly Beneficial Podcast to make the case that American healthcare does not lack solutions. It lacks the will to implement them.
Sacramento, CA, June 11, 2026 --(PR.com)-- Ninety percent of health system markets in the United States are now classified as highly concentrated. They are no longer competitive. The providers in those markets own the market, and they know it. Price signals do not work when one system controls the landscape. Market forces, left alone, will not fix what market failure built.
Peter Hayes spent more than 25 years navigating that reality from the buyer’s side. As Director of Associate Health and Wellness at Hannaford Supermarkets, he managed one of New England’s largest self-insured benefit plans and became an early practitioner of quality-driven benefit design. He later served as President and CEO of the Healthcare Purchaser Alliance of Maine, appointed by two governors to serve on Health Care Reform Commissions along the way. He started out believing the market could solve this. He no longer does.
He sat down with host Vincent Catalano on the CLEARly Beneficial Podcast, released Tuesday, June 2, 2026. Listen now on Substack.
What It Would Actually Take
Hayes came to the conversation with a concrete agenda: growth caps on hospital rates, population-based health payments, an immediate halt to further vertical integration, and state-level regulatory action as the more achievable path forward. Washington, in his view, is too compromised by industry money to lead.
“I have come to the conclusion that we have allowed so much vertical integration and it’s too big to fail,” Hayes said. “Market forces now will not work because 90% of health system markets are highly concentrated. They’re no longer competitive markets. They own the market.”
This episode covered:
Why market forces have failed and what legislative tools can replace them
Hospital rate caps and population-based payment models
The Consolidated Appropriations Act and personal liability for plan sponsors
The 340B federal drug program: how an $82 billion revenue stream lost its public purpose
Tax-exempt hospital status and who is really paying for it
Why broker compensation reform is inseparable from benefit cost control
The Wall Street Journal Called the Next Day
The conversation’s most compelling segment centered on a decision Hayes made at Hannaford more than two decades ago. After an employee’s knee replacement at a low-rated facility failed three times, became infected, and cost the self-insured plan over a million dollars, Hayes restructured the benefit. Employees who chose to travel to Singapore for the procedure, where a total knee replacement carried a global fee of $10,000 and a one-year warranty, would have 100 percent of costs covered, including travel for a significant other.
“The Wall Street Journal picked up the article,” Hayes said. “The next day I got calls from hospitals all across America.” A hospital in Maine called asking to match the price and quality standards. They did.
The same principle played out at the alliance level. When the Healthcare Purchaser Alliance of Maine, representing roughly 60 percent of commercial lives in the state, began waiving copays and deductibles for employees who chose Leapfrog A or B rated facilities, Maine went from among the most unsafe hospital markets in the country to receiving national recognition for hospital safety. Purchaser alignment moved the market.
“Employers are getting sick of paying premiums at the level they’re paying,” Catalano added. “That cannot go to $2,000 a single in the next five years. I don’t know where the revolt starts, but it will start.”
About Peter F. Hayes
Peter F. Hayes recently retired as President and CEO of the Healthcare Purchaser Alliance of Maine, and is formerly a principal of Healthcare Solutions and Director of Associate Health and Wellness at Hannaford Supermarkets. Recognized as a national thought leader in strategic benefit design for more than 25 years, he is a co-founder of the Maine Health Management Coalition, has served on advisory boards for Express Scripts and DFINITY Health, and has been appointed by two different Maine governors to serve on Health Care Reform Commissions. He has also been involved nationally with the Center for Health Innovation, Care Focused Purchasing, and Leapfrog.
About Vincent Catalano and CLEAR Healthcare Solutions
Vincent Catalano is the founder and CEO of CLEAR Healthcare Solutions and host of the CLEARly Beneficial Podcast. With over 23 years of experience in employee benefits and healthcare consulting, including senior roles at Arthur J. Gallagher, Catalano founded CLEAR Healthcare Solutions to provide independent, unbiased healthcare benefits consulting. His position outside corporate constraints allows him to speak candidly about industry issues that others cannot. New episodes of the CLEARly Beneficial Podcast release weekly. Learn more at www.clearhcs.com.
Tune In
Buzzsprout - https://www.buzzsprout.com/2526095
Substack - https://clearlybeneficialpodcast.substack.com
YouTube - https://www.youtube.com/@CLEARlyBeneficialPodcast
Peter Hayes spent more than 25 years navigating that reality from the buyer’s side. As Director of Associate Health and Wellness at Hannaford Supermarkets, he managed one of New England’s largest self-insured benefit plans and became an early practitioner of quality-driven benefit design. He later served as President and CEO of the Healthcare Purchaser Alliance of Maine, appointed by two governors to serve on Health Care Reform Commissions along the way. He started out believing the market could solve this. He no longer does.
He sat down with host Vincent Catalano on the CLEARly Beneficial Podcast, released Tuesday, June 2, 2026. Listen now on Substack.
What It Would Actually Take
Hayes came to the conversation with a concrete agenda: growth caps on hospital rates, population-based health payments, an immediate halt to further vertical integration, and state-level regulatory action as the more achievable path forward. Washington, in his view, is too compromised by industry money to lead.
“I have come to the conclusion that we have allowed so much vertical integration and it’s too big to fail,” Hayes said. “Market forces now will not work because 90% of health system markets are highly concentrated. They’re no longer competitive markets. They own the market.”
This episode covered:
Why market forces have failed and what legislative tools can replace them
Hospital rate caps and population-based payment models
The Consolidated Appropriations Act and personal liability for plan sponsors
The 340B federal drug program: how an $82 billion revenue stream lost its public purpose
Tax-exempt hospital status and who is really paying for it
Why broker compensation reform is inseparable from benefit cost control
The Wall Street Journal Called the Next Day
The conversation’s most compelling segment centered on a decision Hayes made at Hannaford more than two decades ago. After an employee’s knee replacement at a low-rated facility failed three times, became infected, and cost the self-insured plan over a million dollars, Hayes restructured the benefit. Employees who chose to travel to Singapore for the procedure, where a total knee replacement carried a global fee of $10,000 and a one-year warranty, would have 100 percent of costs covered, including travel for a significant other.
“The Wall Street Journal picked up the article,” Hayes said. “The next day I got calls from hospitals all across America.” A hospital in Maine called asking to match the price and quality standards. They did.
The same principle played out at the alliance level. When the Healthcare Purchaser Alliance of Maine, representing roughly 60 percent of commercial lives in the state, began waiving copays and deductibles for employees who chose Leapfrog A or B rated facilities, Maine went from among the most unsafe hospital markets in the country to receiving national recognition for hospital safety. Purchaser alignment moved the market.
“Employers are getting sick of paying premiums at the level they’re paying,” Catalano added. “That cannot go to $2,000 a single in the next five years. I don’t know where the revolt starts, but it will start.”
About Peter F. Hayes
Peter F. Hayes recently retired as President and CEO of the Healthcare Purchaser Alliance of Maine, and is formerly a principal of Healthcare Solutions and Director of Associate Health and Wellness at Hannaford Supermarkets. Recognized as a national thought leader in strategic benefit design for more than 25 years, he is a co-founder of the Maine Health Management Coalition, has served on advisory boards for Express Scripts and DFINITY Health, and has been appointed by two different Maine governors to serve on Health Care Reform Commissions. He has also been involved nationally with the Center for Health Innovation, Care Focused Purchasing, and Leapfrog.
About Vincent Catalano and CLEAR Healthcare Solutions
Vincent Catalano is the founder and CEO of CLEAR Healthcare Solutions and host of the CLEARly Beneficial Podcast. With over 23 years of experience in employee benefits and healthcare consulting, including senior roles at Arthur J. Gallagher, Catalano founded CLEAR Healthcare Solutions to provide independent, unbiased healthcare benefits consulting. His position outside corporate constraints allows him to speak candidly about industry issues that others cannot. New episodes of the CLEARly Beneficial Podcast release weekly. Learn more at www.clearhcs.com.
Tune In
Buzzsprout - https://www.buzzsprout.com/2526095
Substack - https://clearlybeneficialpodcast.substack.com
YouTube - https://www.youtube.com/@CLEARlyBeneficialPodcast
Contact
CLEAR Healthcare Solutions
Vincent Catalano
(916) 284-6973
www.clearhcs.com
Vincent Catalano
(916) 284-6973
www.clearhcs.com
Contact
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