November 25, 2015 – eNewsletter

{IN THIS ISSUE}

  • LAN Events
  • Upcoming Webinars
  • Work Group Updates
  • Of Interest

Engaging Patients in APMs: LAN Learnings December Webinar

Patient in hospital

Want to learn how to better engage patients in alternative payment models (APMs)? Our upcoming webinar on Wednesday, December 2 features moderator Alan Balch (Patient Advocate Foundation), Shelley Fuld Nasso (National Coalition for Cancer Survivorship), Lauren Kennedy (National Partnership for Women and Families), and Sara Van Geertruyden (Partnership to Improve Patient Care). Panelists will share several approaches and discuss how patients can serve as partners in building a patient-centered health system. Guiding Committee co-chair Mark Smith will also share key progress updates from the Guiding Committee and the three LAN work groups currently underway.

Recap of Population-Based Payments Webinar

On Tuesday, November 10, the LAN hosted a webinar on population-based payments. Robert McConville shared how Intermountain has worked to align provider financial incentives, David Muhlestein of Leavitt Partners explained how different providers are engaging and succeeding in APMs and Kerry Snyder and Allison Yudt from Populytics, Inc. provided examples of how different kinds of Accountable Care Organization (ACOs) can be managed. The panel addressed audience questions and comments on topics such as clinical episode payments for hip and joint replacements and quality data sharing in light of Stark Law regulations. To listen to the recording or view the slide deck, visit our webinar archive.

Save these dates for upcoming webinars

December 2,  2 – 3:15 PM ET
January 12, 12 – 1:15 PM ET
February 9, 12 – 1:15 PM ET
Stay tuned for topics and registration links.
Learn more about previous webinars and view our webinar archive.

Guiding Committee (GC) Updates

On Friday, November 13, the LAN Guiding Committee heard updates from
representatives of its three work randomgroups, including the Alternative Payment Model Framework and Progress Tracking Work Group (APM FPT), which has been collecting and synthesizing feedback on the APM Framework Draft White Paper. The Guiding Committee also discussed legal and regulatory hurdles that providers and payers may face when establishing or participating in APMs and reviewed the highlights and lessons learned from the recent LAN Summit in October. Stay tuned for the full summary from the meeting.

Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group

On Thursday, November 12, members of the APM FPT Work Group met to
discuss comments received on the APM Framework Draft White Paper received to date. Comments have been collected apm frameworkfrom the LAN Summit and recent listening sessions conducted via webinar – on November 9one for states and on November 13 one for consumer and patient advocates and also one for purchasers – as well as many other comments provided by LAN participants. In addition, two representatives of the Catalyst for Payment Reform (CPR) led the group in discussing APM measurements.   The first of LAN’s three work groups launched, the APM FPT Work Group is charged with recommending a set of specific, easy-to-understand terms and definitions to serve as a foundation for the LAN’s work. The group is also proposing an approach for measuring APM adoption across the U.S. health care system that includes clarity on what should be measured, along with a set of categories that enable meaningful reporting. The LAN will measure progress toward APM adoption following the work group’s recommendations. Find work group meeting summaries here.

Population-Based Payment (PBP) Work Group

The PBP Work Group met in person on Thursday, November 5, to address a set of priority issues for which it is believed alignment of methods across payers will accelerate adoption of PBP models that support better health outcomes at lower costs. The PBP Work Group is organized through a series of “sprints” in the next six months to quickly address these topics in a short time frame, starting with patient attribution and financial bench-marking. Patient attribution is the method used to connect a patient to a medical group or delivery system within a PBP model. Financial benchmarking is the approach to set a financial target for the PBP model. More information on this work group is here.

Clinical Episodes Payment (CEP) Work Group

At its first in-person meeting, held on Monday, November 16, the CEP Work Group kicked-off its efforts, bringing together payers, providers, states, and consumer advocates to advance the deployment of effective clinical episode-based payment models that drive and support better health outcomes for patients at a lower cost. The work group came to consensus on its charge: to identify payment strategies and align innovations within and across the private sectors.   Members also came to consensus on the subjects of its three episode sprints:  1) Total Hip Replacement (for patients with osteoarthritis and/or fracture) and Total Knee Replacement (for patients with osteoarthritis); 2) Maternity Care; and 3) Cardiac Care. For each of these episodes, the work group will consider the following design elements from the perspective of how to elicit the optimal outcome for the patient:

  • The start point and length of each episode;
  • The relative levels of accountability and risk involved;
  • Strategies for establishing target price and benchmarks;
  • Appropriate quality metrics (including both clinical quality and patient-reported measures); and
  • The data systems that would be needed to eventually bring episode payment to scale across multiple payer and provider types.

Meeting information will be posted here.

New Rule on Joint Replacementknees

The Centers for Medicare & Medicaid Services (CMS) r
eleased a new bundled
payment model for hip and knee replacements. Learn more about this comprehensive care model and download the consumer fact sheet, provider fact sheet, and frequently asked questions (FAQs).

In the News: LAN Summit

In case you missed it, here’s a news round-up from Politico about the recent LAN Summit as well as a recent blog from Bloomberg BNA that highlights private sector involvement in the LAN.

LAN Summit logo

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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