February 23, 2016 – eNewsletter

The draft white paper, entitled Accelerating and Aligning Clinical Episode Payment Models: Elective Joint Replacement, provides recommendations for how to design patient-centered episode payment for elective hip and knee replacement. More specifically, the paper discusses the Work Group’s recommendations for those design elements and operational considerations that support clinical episode payment adoption across a broad set of health plans, providers, and purchasers.

The CEP Work Group is collecting feedback in three ways on the draft White Paper and its specific recommendations: through an online discussion forum on Handshake, comments submitted directly on the LAN website, and via email at PaymentNetwork@MITRE.org

In addition to collecting input to the draft elective joint replacement white paper, the CEP Work Group is simultaneously working on framing two additional episodes: cardiac care and maternity care. The Work Group is developing some preliminary recommendations, which will be shared in April.

In setting priorities for 2016, the GC emphasized that the focus should be on “action.” The LAN should build on the white paper recommendations by moving towards pilots in partnership with other organizations. The GC also emphasized that time is limited and that there is a need to prioritize carefully based on what’s achievable. The next step is to further shape the higher priority items.

During the meeting, GC members also provided feedback on preliminary plans for forming a new work group to identify and develop steps for reducing cost and increasing the impact of evaluations of payment reform. The GC emphasized the importance of this work, noting that better evidence through more efficient and effective evaluation can lead to better payment reform design, more rapid diffusion of payment reforms, and better results for patients. This work would be supported by the Arnold Foundation and the Duke-Margolis Center for Health Policy.