October 23, 2015 – eNewsletter

{IN THIS ISSUE}

  • Stakeholder Event
  • Upcoming Webinars
  • Work Group Corner
LAN Summit logo

We are just a few days away from the LAN Summit! JoiAndy Slavittn fellow innovators from health systems, health plans, purchasers/employers, federal and state government, consumer groups, patient advocates, experts and others who are designing or have implemented alternative payment models.

Keynote by Andy Slavitt, Acting Administrator for the Centers for Medicare & Medicaid Services

See the LAN Summit website for detailed information on the agenda, speakers, hotel, transportation, local food options and more.

  • Choose from 14 breakout sessions on a range of case studies
  • Join brown bag sessions for States or Consumers to share with colleagues
  • Participate in Payment Primer or Leadership Listening sessions
  • ‘Understand the Connection’ at the Special session on LAN and MACRA
  • Provide your comments at the presentation of the APM Framework Draft White Paper.

Tweet Us. We want to hear what you are most looking forward to learning at the Summit. Tweet @Payment_Network using #LANSummit.

Save these dates for upcoming webinars

November 10  1 – 2:15 PM ET  
December 2   2 – 3:15 PM ET
January 12 Time TBD
February 9 Time TBD
Stay tuned for topics and registration links

Population Based Payment (PBP) Work Group Kicks Off

This past Wednesday, October 21, 2015 the PBP Work Group held their kickoff meeting. The meeting agenda focused on introducing group members, orienting members to the LAN and discussing the charge of the work group. A majority of the meeting was devoted to planning for upcoming activities including reviewing proposed focus areas (patient attribution, financial benchmarking, quality measurement and data sharing). Members agreed on a goal to identify best practices for accelerating adoption of PBP models that improve quality, patient experience, and health status, while keeping in mind differences in communities, markets, and governance structure.  A member roster is posted on the LAN Website.

Clinical Episodes Payment (CEP) Work Group Chair Appointed

Lewis G. Sandy, MD, MBA, is Senior Vice President, Clinical Advancement, at UnitedHealth Group. His work focuses on clinical innovation, payment/delivery reforms to modernize the health care system, and physician collaboration. He also is a principal in the UnitedHealth Center for Health Reform and Modernization, with a focus on payment/delivery innovation and policy.

Q: Why was chairing this group of interest to you?
The HCLAN is working across diverse stakeholders to promote value-based payment models.  Episode-based payment models can be challenging, but they also offer the potential to improve quality, promote affordability, and enhance the patient experience in selected clinical areas. I look forward to working with the group on these challenges.

Q: What are the main products that this group will produce?
The work group will focus on a select number of clinical conditions and work collaboratively to specify the major elements of episode-based payment for these clinical conditions. We expect to draw extensively from previous and current bundled and episode-based payment programs and initiatives, as well as insights from clinicians, patients/consumers, care delivery systems and other stakeholders.

Q: How will the CEP Work Group get the clinical and technical knowledge they need?
While the work group itself will be comprised of experts from a number of areas, we also envision utilizing technical expert panels in the selected clinical areas.

Q: What are the initial areas of focus for the CEP Work Group?
While the work group has not yet formally convened, the LAN Guiding Committee has suggested joint replacement surgery as one potential area of focus for the work group. I would expect the group to look at both procedure-based episodes such as a surgical procedure, and condition-based episodes that span a longer time period. 

APM Framework and Progress Tracking Work Group Releases Draft White Paper
The APM FPT Work Group has released its Draft Framework White Paper and invites you to comment on the draft through November 20, 2015. Dr. Sam Nussbaum, Chair, will be presenting the draft at the LAN Summit October 26. Comments will be accepted on the LAN collaboration portal or by email. See here for more information on submitting comments.

The White Paper describes the approach that the work group used to develop the proposed APM Framework and then delineates and describes principles upon which the APM Framework is based. With these principles in mind, the paper differentiates the categories within the APM Framework, by explaining how the categories are described, and where the boundaries between them lie.  In order to further clarify the classification of individual APMs, case studies will be used to exemplify each of the categories and subcategories in the APM Framework.

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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