Important Medicare Announcement
- March 3, 2016
- Posted by: Health Care Payment Learning & Action Network
- Category: LAN Update
We are pleased to share with you an important announcement involving payment reform in Medicare. As you recall, our shared goal in the LAN is to get 30% of health care payments in alternative payment models by the end of 2016 and 50% by the end of 2018. Today, President Obama announced that Medicare met the 30% goal in January of 2016, almost a year ahead of schedule. As you can see from the note below, Patrick Conway, the CMS Principal Deputy Administrator, commented on the important role of the Health Care Payment Learning & Action Network (LAN) in helping Medicare reach this goal; indeed, the announcement relies on the LAN’s payment reform framework. While we all still have much more to do in terms of payment that supports better care for patients and lower costs, this progress reflects the contributions of many LAN members. We thank you for that, and look forward to our next steps.
Mark Smith and Mark McClellan
Co-Chairs of the LAN Guiding Committee
Dear LAN Guiding Committee Members,
Earlier today, the President announced two landmark achievements for the U.S. health care system since the passage of the Affordable Care Act. First, more than 20 million Americans have gained health insurance. We have the lowest uninsured rate ever recorded. Second, as of January 2016, more than 30% of Medicare Part A and B payments are tied to alternative payment models. This latter milestone is particularly important to our shared work with the Health Care Payment Learning & Action Network (LAN) and follows the U.S. Department of Health and Human Services’ challenge to us all to shift the way we pay for health care away from the quantity of services to the quality and value of care we provide. CMS is proud to achieve the 30% target almost a year ahead of schedule, and we appreciate that we would not have been able to do this without the help of you and the LAN. Moreover, we know that true transformation of our health system cannot be done through Medicare alone, and so we look forward to continuing to work with the LAN membership at-large to achieve the goals of tying 30% of spending to APMs by the end of 2016 and 50% by the end of 2018 for the entire U.S. health care system. We encourage anyone who has not set specific goals to consider doing so, and to join the LAN effort to track progress across the public and private sector. Working together we can implement new payment models, learn what works, scale successes, and improve patient care. We can deliver on the promise of a health system that achieves better care, smarter spending, and better health outcomes for everyone in our health system. Thank you for your service on the LAN and for your leadership in this effort.
Warm regards,
Patrick Conway
Policy Makers
Enabling Organizations | 
Community-Based 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.
