{IN THIS ISSUE}

  • Payment Models focused on Low-Income and Vulnerable Populations: LAN Learnings in October
  • Guiding Committee Update
  • Upcoming Webinar
  • Work Group Corner
  • Webinar Recap: LAN
  • Learnings in September
  • LAN Summit

Join us for “LAN Learnings in October”, a LAN webinar on October 15 from 12:30-1:45 PM ET, to get updates on LAN activities and hear about an innovative payment reform approach focused on low income and vulnerable populations in New Jersey.  Since the last webinar, the LAN Guiding Committee is working to launch new work groups, stand up affinity groups, partner with the Core Quality Measures Collaborative on performance measures, and prepare for the first LAN Summit in Arlington, Virginia. The Guiding Committee will also hold its second in-person meeting on September 30/October 1, to continue advancing LAN goals. LAN Guiding Committee Co-Chair Mark McClellan will share updates on these activities during this webinar.

In the second part of the webinar you will hear from panelists discussing the Medicaid payment reform initiative occurring in New Jersey. This model promotes accessible, coordinated, patient-centered care that focuses on health and disease prevention and reduces health care costs. Invited speakers represent Rutgers University, Camden Coalition of Healthcare Providers, UnitedHealthcare, and the New Jersey Division of Medical Assistance and Health Services to share how New Jersey has implemented this model, how the it is working, what lessons have been learned so far, and plans for evaluation and performance feedback to Accountable Care Organizations (ACOs).

The LAN Guiding Committee held a virtual meeting on September 11. Sam Nussbaum, chair of the APM Framework and Progress Tracking Work Group, shared the group’s efforts to develop guiding principles and an APM category framework to inform the Population Based Payment (PBP) and Clinical Episodes Payment (CEP) work groups. Members supported a proposal to share this interim work with the affiliated community through the LAN collaboration portal in order to incorporate feedback from the broader LAN community early in the development process (Handshake).  The Guiding Committee co-chairs shared plans to partner with the Core Quality Measures Collaborative. They also updated members on selection of chairs and members for the next two work groups. CMS staff provided an update on plans to launch a purchaser and a consumer/patient affinity group in the next few weeks.

Members reviewed goals and activities for expanding broad awareness about payment reform and for engaging and equipping key stakeholders. A communications and engagement plan will be provided for review at the next Guiding Committee meeting.

The Guiding Committee is planning an exciting LAN Summit on October 26, and looks forward to meeting with key stakeholders in Arlington, VA. A detailed summary of this meeting will be posted on the Guiding Committee page.

Save these dates for upcoming webinars

October 15   12:30 – 1:45 PM ET
November 10  1 – 2:15 PM ET
December 2   2 – 3:15 PM ET
Stay tuned for topics and registration links.

APM and Framework Progress Tracking Work Group Update

The work group held an in-person meeting on August 27 and a virtual meeting on September 18. The meeting summaries will be posted on the work group page.

Population Based Payment (PBP) Work Group Co-chairs Appointed

We are pleased to announce Glenn Steele, Jr, MD, PhD, Chairman, xG Health Solutions, Inc., and immediate past President and CEO, Geisinger Health System and Dana G. Safran, Sc.D., Senior Vice President Performance Measurement and Improvement, Blue Cross Blue Shield of Massachusetts as co-chairs of the PBP Work Group. The membership of the group will be announced soon, with an anticipated launch in early October.

 

Clinical Episodes Payment (CEP) Work Group Chair Appointed

We are pleased to announce Lewis Sandy, MD, MBA, Executive Vice President, Clinical Advancement, UnitedHealth Group, as chair of the CEP Work Group. The membership of the group will be announced soon, with an anticipated launch in early November.

This month’s ‘LAN Learnings’ webinar provided a robust discussion on September 9. Mark Smith, Co-Chair of the LAN Guiding Committee, reviewed the APM Framework and Progress Tracking Work Group’s recent work, described the soon-to-be-launched work and affinity groups (named above), and noted the new partnership with the Core Quality Measurement Collaborative to accelerate payment reform.  He encouraged participants to save the date for the LAN Summit on October 26, 2015.  You can register for the Summit here.   This webinar featured a partnership of Hill Physician Medical Group, Dignity Health and Blue Shield of California on a virtual ACO that serves Cal-PERS, where each partner monitors quality, takes financial risk and has been able to pass cost savings onto employers.

Septemeber 22 pic 1  Kristen Miranda, Senior Vice President, Strategic Partnerships and Innovations, Blue Shield of California, reported the early work of the group was a response to unsustainable health care cost trends and a recognition that over 40,000 members from a single employer group were being served by the partnering medical group and hospital.

 

Rosaleenseptember 22 pic 2 Derington, Chief Medical Services Officer, Hill Physician Medical Group, described how combined governance was critical to success, as wassupport by a Core Team that looks at both financial commitments and the quality of care.

 

 

Cheri Galt, september 22 pic 3Director, Managed Care and Clinical Integration, Dignity Health, noted how they first developed aligned financial incentives with top to bottom buy-in from all three organizations.  $125M in savings (rebates) has been generated over time for the single employer group.

 

Access webinar archives here.

LAN Summit logo

Join fellow innovators from health systems, health plans, consumer groups, large employers, federal, state, and local governments, experts and others who are designing or have implemented alternative payment models. At this first LAN Summit, you will:

  • meet LAN Guiding Committee members
  • hear updates from the APM Framework and Progress Tracking Work Group
  • engage with fellow APM innovators
  • understand best practices for engaging patients in APMs
  • go home with the knowledge and tools needed to successfully transition your organization or constituency to alternative payment models.

Whether your organization is just beginning to explore APMs or has been running a high quality, high value payment model for years, this event will support you as you Engage, Learn, and Act. Register here.

CAMH Team Members banner

Anne Gauthier, Project Leader

Amy Aukema, Deputy Project Leader

Kris Prendergast, Communications Lead

Chris Izui, Work Group Lead

Jamel Morris, Work Group Lead

Heather Grimm, Communications Specialist

Collin Scheible, Healthcare Analyst

Mary Jo Deering, Consultant

Heidi Giles, Program Manager

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.

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