- February 8, 2016
- Posted by: Health Care Payment Learning & Action Network
- Categories: LAN Update, Work Product Releases
The public comment period for the draft Patient Attribution and Financial Benchmarking White Papers are now open. The Population-Based Payment (PBP) Work Group invites you to comment on the draft white papers now through Monday, March 7.
Key Next Steps
- Monday, February 8: Comment period open
- Tuesday, February 9 @ 12:00 -1:30 PM ET: LAN Update Webinar – Accelerating and Aligning Population-Based Payment Models: Preliminary Recommendations on Patient Attribution and Financial Benchmarking (register)
- Monday, March 7: Comment period closes
- Monday, April 4: Presentation of the final White Papers
Overview of the Draft White Papers
The draft white paper titled Accelerating and Aligning Population-Based Payment Models: Patient Attribution describes the method by which patient populations are assigned to providers who are accountable for total cost of care and quality outcomes for their designated populations in a PBP model. The paper recommends that active, intentional identification or self-reporting by patients should be considered first. The paper also outlines nine additional recommendations that payers and providers can use when making decisions on attribution in their PBP models.
The draft white paper titled Accelerating and Aligning Population-Based Payment Models: Financial Benchmarking describes approaches for setting an initial benchmark and updates over time and also addresses risk adjustment considerations. The white paper discusses the need to balance voluntary participation with the movement towards convergence in a market with providers at different starting points.
Information and positions taken in these documents should be considered preliminary until the Work Group receives input from the LAN and releases final versions of the White Papers.
What Feedback Are We Seeking?
Your comments will help to refine the final Patient Attribution and Financial Benchmarking White Papers, both of which are targeted for release later this year. In particular, the Work Group is seeking feedback on:
- the overall White Paper and recommendations;
- diagrams, flowcharts and tables used to illustrate key concepts; and
- examples that would be useful for illustrating the recommendations.
How Will We Collect Feedback?
The PBP Work Group will be collecting feedback:
- online through a discussion forum on Handshake (Instructions)
- through the LAN Website:
- Patient Attribution Comment Form
- Financial Benchmarking Comment Form
If the options listed above are unavailable for any reason, feel free to submit comments via e-mail at paymentnetwork@mitre.org
The Work Group requests feedback by Monday, March 7, 2016. We appreciate your involvement and look forward to your input.
Purchasers
Policy Makers
Community Organizations
Enabling Organizations | 
Emily DuHamel Brower, M.B.A., is senior vice president of clinical integration and physician services for Trinity Health. Emphasizing clinical integration and payment model transformation, Ms. Brower provides strategic direction related to the evolving accountable healthcare environment with strong results. Her team is currently accountable for $10.4B of medical expense for 1.6M lives in Medicare Accountable Care Organizations (ACOs), Medicare Advantage, and Medicaid and Commercial Alternative Payment Models.
Mr. James Sinkoff is the Deputy Executive Officer and Chief Financial Officer for Sun River Health (formerly known as Hudson River HealthCare), and the Chief Executive Officer of Solutions 4 Community Health (S4CH); an MSO serving FQHCs and private physician practices.
Victor is the Chief Medical Officer for TennCare, Tennessee’s Medicaid Agency. At TennCare, Victor leads the medical office to ensure quality and effective delivery of medical, pharmacy, and dental services to its members. He also leads TennCare’s opioid epidemic strategy, social determinants of health, and practice transformation initiatives across the agency. Prior to joining TennCare, Victor worked at Evolent Health supporting value-based population health care delivery. In 2013, Victor served as a White House Fellow to the Secretary of Health and Human Services. Victor completed his Internal Medicine Residency at Emory University still practices clinically as an internist in the Veteran’s Affairs Health System.
Dr. Brandon G. Wilson, DrPH, MHA (he, him, his) joined Community Catalyst as the Director of the Center for Consumer Engagement in Health Innovation, where he leads the Center in bringing the community’s experience to the forefront of health systems transformation and health reform efforts, in order to deliver better care, better value and better health for every community, particularly vulnerable and historically underserved populations. The Center works directly with community advocates around the country to increase the skills and power they have to establish an effective voice at all levels of the health care system. The Center collaborates with innovative health plans, hospitals and providers to incorporate communities and their lived experience into the design of systems of care. The Center also works with state and federal policymakers to spur change that makes the health system more responsive to communities. And it provides consulting services to health plans, provider groups and other health care organizations to help them create meaningful structures for engagement with their communities.
Tamara Ward is the SVP of Insurance Business Operations at Oscar Health, where she leads the National Network Contracting Strategy and Market Expansion & Readiness. Prior to Oscar she served as VP of Managed Care & Network Operations at TriHealth in Southwest Ohio. With over 15 years of progressive health care experience, she has been instrumental driving collaborative payer provider strategies, improving insurance operations, and building high value networks through her various roles with UHC and other large provider health systems. Her breadth and depth of experience and interest-based approach has allowed her to have success solving some of the most complex issues our industry faces today. Tam is passionate about driving change for marginalized communities, developing Oscar’s Culturally Competent Care Program- reducing healthcare disparities and improving access for the underserved population. Tamara holds a B.A. from the University of Cincinnati’s and M.B.A from Miami University.
Dr. Peter Walsh joined the Colorado Department of Health Care Policy and Financing as the Chief Medical Officer on December 1, 2020. Prior to joining HCPF, Dr. Walsh served as a Hospital Field Representative/Surveyor at the Joint Commission, headquartered in Oakbrook Terrace, Illinois.
