LAN Learnings November 2015 Q&A

November 10, 2015

Co-presenters answer participants’ questions on population-based payments that were not answered during the webinar.

David Muhlestein - Leavitt Partners

At LVHN, our Achieving Clinical Excellence (ACE) provider incentive program includes both commercial and multipurpose senior services program (MSSP) ACO populations, but we do not currently include any Medicare Advantage lives. However, the current ACE program will be expanded to include Medicare Advantage lives when these value-based Medicare Advantage contracts become effective.

At LVHN, our ACE provider incentive program has included an incentive for end-of-life planning for several years. We have temporarily had to suspend this with the switch to a new electronic medical record (EMR) system, but we are looking to revive and expand it in the near future.

There are no specific measures related to behavioral health in the ACE provider incentive program at LVHN today. However, it is an area of growing interest.

At LVHN, our ACE incentive program is based on the patient population that actually utilizes our services, coupled with those in the MSSP ACO who are attributed to LVHN, regardless of the extent to which they seek services outside our network. Since ACE is built around influencing behaviors of our physicians and we have no way of assigning patients from various geographic regions to particular physicians or practices, ACE does not take such an approach.

Allison Yudt and Kerry Snyder - Populytics, Inc.

We have looked a lot at which medical groups are forming ACOs and we have done some evaluations of the physicians who are participating in them. Feel free to contact us for more information.

We have not seen much of a movement toward this. It’s possible that ACOs that work closely with a public health agency, such as some Medicaid ACOs, may adopt some of the measures, but I don’t expect it to happen broadly.

David Muhlestein, PhD, JD, serves as a member of the Health Care Payment Learning & Action Network's Population-Based Payment Work Group. He is Senior Director of Research and Development at Leavitt Partners, LLC, where he directs the study of accountable care organizations through the LP Center for Accountable Care Intelligence and leads the firm’s quantitative evaluation of health care markets.

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