Provider Perspectives Listening Session – December 16
Are you a clinician, hospital worker, or member of a provider organization? If so, please join us on Wednesday, December 16, from 12 – 1:15 pm ET for a listening session to solicit provider perspectives on the APM Framework Draft White Paper. The APM Framework defines payment model categories and will be used to benchmark efforts to increase the uptake of APMs across the U.S. health system. We are very interested in comments on the draft paper from both provider organizations and on-the-ground clinicians to ensure your perspectives are incorporated. Your feedback will help refine the final product, which is targeted for release in January. Hosted by LAN Project Leader Anne Gauthier, the webinar will include two Work Group member panelists Paul Harkaway (Trinity Health) and Shari Erickson (American College of Physicians). Both Paul and Shari were members of the work group that developed the draft paper and will present a brief overview of it and invite your comments.
Please join us for a very special webinar in the New Year on Tuesday, January 12, from 12 – 1:30 pm ET, when the APM Framework and Progress Tracking (APM FPT) Work Group shares the final APM Framework White Paper. During this webinar Sam Nussbaum, APM FPT Work Group Chair, will summarize the comments received on the paper and provide an overview of how they were incorporated. The webinar will also feature case studies that exemplify categories in the APM Framework. We hope you will join us for this opportunity to hear directly from Work Group members as they present the final White Paper.
From the CEP Chair: Lowering Costs and Improving Care Through Episode Bundled Payments
Even though surgeons perform more than 400,000 hip and knee replacements in the U.S. each year, the quality and cost of care for these surgeries vary widely among providers and across geographic areas. That’s why the Clinical Episode Payment (CEP) Work Group is examining alternative payment models for hip and knee replacement surgery as part of its first charge. Given the interest in and variety of bundled payment approaches for joint replacement, focusing on this kind of procedure is a great way to assess current understanding and best practices from the field. Read our latest blog by CEP Work Group Chair Lewis Sandy to learn more.
Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group.
The APM FPT Work Group is in the process of reviewing comments received on the APM Framework Draft White Paper and revising the paper. The Work Group, Guiding Committee, and CAMH team thank everyone who provided thoughtful feedback. We received more than one hundred substantive comments from nearly eighty unique individuals with suggestions on how to strengthen the paper. More than fifty percent of those who submitted comments represent organizations. Stakeholders provided comments through a variety of channels, including the LAN Summit, LAN Listening Sessions, and on Handshake and social media, The APM FPT Work Group looks forward to sharing the final APM Framework White Paper during an upcoming webinar on January 12. Please sign up here to attend. The Work Group has launched its effort to measure progress in adoption of APMs and is currently updating draft metrics and making refinements based on feedback that include clarity on what should be measured and how. The Work Group is also exploring opportunities to “pressure-test” these metrics. A timeline for this measurement effort will be established soon. Learn more info about the APM FPT Work Group and view its meeting archives here.
Population-Based Payment (PBP) Work Group
On November 24, the PBP Work Group met virtually to discuss two key components of population-based payment models: patient attribution and financial benchmarking. Participants discussed an approach to patient attribution that starts with patient choice or attestation, followed methods to identify patient visits with a primary care provider responsible for overall care coordination. This is important to help improve health outcomes for patients, with patient attribution linking the patient to a provider group accountable for overall care management and the cost of care. Also highlighted was the importance of overall transparency throughout the patient attribution process. Participants also discussed principles within a voluntary PBP model that includes setting the initial financial benchmark based on historic provider group costs and local market forces and updating the financial benchmark by moving toward a regional benchmark. The Work Group will be presenting key recommendations to the LAN Guiding Committee and is developing a white paper to highlight important findings. Learn more info and view the PBP Work Group archives here.
Clinical Episode Payment (CEP) Work Group
On December 1, the CEP Work Group held a virtual meeting to continue developing a set of recommendations and options to facilitate adoption of joint replacement episode payment. Hip and knee replacement is a priority topic for the Work Group, given the high volume of surgeries performed each year. The Work Group walked through a draft document that included preliminary recommendations from the November 16 in-person meeting and offered feedback that will help shape the format of the paper, with a goal of creating a product that identifies not only a potential road map for joint replacement but also elements of episode design that may be common across multiple conditions or procedures. Some of these design elements include start point and length of each episode, relative levels of accountability and risk involved, strategies for establishing target price and benchmarks, appropriate quality metrics, and data systems needed to bring episode payments to scale. Underlying all of these design elements is the need to ensure that episodes support better quality and outcomes for patients. View the CEP Work Group archives here.
Last month, Health Affairs published a blog that highlights a new policy brief focused on four potential payment models that could help reduce health care costs. The Centers for Medicare and Medicaid Services (CMS) is currently testing these models to see if a single, bundled approach could help reduce Medicare spending.
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.