The Health Care Transformation Task Force brings together providers, payers, purchasers, and patient representatives to align public and private sector efforts to transform the U.S. health care system. Dr. Richard Gilfillan, Task Force Chair, spoke with a member of the CAMH team on June 24.
Gilfillan: Our goal is to simplify the path for delivery system transformation for our members and, we hope, more broadly for the country at large, so we can accelerate progress toward a health care system that achieves the Triple Aim. We aspire to leverage the collective experience of our members and share those learnings and recommendations with the entire health care community.
We believe that the central issue is to get payment methodologies in place that support organizations going down this pathway. We have multiple strategies. First, we’d like to set an example and demonstrate what is possible if we make a firm commitment to our aim of having 75% of our respective businesses operating under value-based payment arrangements by 2020. We’ll try to be leaders for the industry. Second, we want to give input to public policy makers to encourage the development of payment models that are optimally supportive of organizations making that transition. Third, we want to develop common approaches to alternative payment models in the private sector so that the private and public sectors are better aligned. Fourth, we’d like to identify best practices for payment and delivery models that we can make available to members and others.
The cornerstone of our strategy is that as a multi-sector organization that includes payers, providers, employers, and consumer representatives, we can develop solutions that are workable for all and in the best interest of the system as a whole.
Gilfillan: It would be useful for the LAN to look at the current environment we’re operating in and ask, given these circumstances, what strategy would best facilitate meeting the Secretary’s goals. Developing a recommended strategy and a set of principles to guide decision making regarding the details of payment policy would be very valuable. Then we can start laying out key issues and opportunities that need to be addressed to encourage people to go down the path.
There is more than enough information about how to deliver higher value care. The really difficult issues are the payment models to promote that and the operational issues between payers, providers, employers, and consumers that get in the way. I think developing shared recommendations around payment issues, like benchmarking and rebasing as well as operational issues like provision of data and waivers, could make a real difference. I think the LAN could also conduct a review of alternative payment models that are in operation today and identify the approaches taken to these key issues. An inventory like this could inform all of our work through sharing the wisdom gained by organizations across the industry over many years. I believe the system is poised to move rapidly toward a new model. However, to get more organizations aggressively moving, we need to create reasonable opportunities for success early on. CMS, and all sectors, will ultimately benefit from the momentum built on early wins.
Gilfillan: We would like to help on those key tasks of developing a strategy and priority issues to be addressed. We have already done some work in these areas, including defining “what counts” toward our goal of 75% of our businesses in valuebased payment by 2020, as well as helping to identify standardized approaches to issues like simplifying quality measures, beneficiary attestation, and benchmarking that could be used across public and private sectors. Aligning these efforts will simplify and accelerate the work of transformation for everyone. We look forward to sharing all the work we have done to date and want to be very engaged and supportive of the LAN’s efforts.
To achieve the goal of better care, smarter spending, and healthier people, the U.S. health care system must substantially reform its payment structure to incentivize quality, health outcomes, and value over volume. The Health Care Payment Learning and Action Network (LAN) was established as a collaborative network of public and private stakeholders, including health plans, providers, patients, employers, consumers, states, federal agencies, and other partners within the health care community.