March 22, 2016 – eNewsletter

Participate alongside many of the major health plans who have already joined HHS and the LAN in a nationwide data collection and play a key role in advancing payment reform.
 
The LAN is currently recruiting public and private health plans to volunteer to participate in the alternative payment model (APM) data collection effort. Results from this effort will help the LAN assess APM progress towards goals of 30% in APMs by 2016 and 50% by 2018. Please send an email to paymentnetwork@mitre.org for more information.

The public comment period for the draft white paper released by the Clinical Episode Payment (CEP) Work Group closes next Monday, March 28. The paper provides recommendations for how to design patient-centered episode payment for elective hip and knee replacement. Please submit your input on the elective joint replacement white paper this week! To provide feedback, use Handshake, the online elective joint replacement comment form, or email at PaymentNetwork@MITRE.org

Join us for a special listening session for payers today from 11 am – 12:15 pm EST. This webinar will offer an overview of the CEP Work Group’s recommendations and look at successful elements of clinical episode payment models for elective hip and knee replacement. Lewis Sandy (UnitedHealth Group) and Steve Spaulding (Arkansas Blue Cross Blue Shield) will share their experiences implementing clinical episode payments from the payer perspective and solicit your questions and feedback.  

The Guiding Committee (GC) held its monthly teleconference on Wednesday, March 9 to bring GC members up to speed on the progress of the Population-Based Payment (PBP) Work Group on its performance measurement and data sharing sprints. In addition, GC members provided their feedback and suggestions for evolving the LAN Summit agenda and for recruiting organizations to become committed partners of the LAN. The GC also discussed upcoming plans as the LAN embarks on its second year. The top three priorities identified by GC members are as follows:

1. Advance adoption of LAN-recommended Population-Based Payment (PBP) and CEP approaches though a pilot or other implementation-focused work effort 
2. Establish a new group focused on primary care payment models 
3. Establish a new group for developing better evidence on payment reform 

Stay tuned for more information on each. 

To help the LAN assess the extent to which health care plans are adopting APMs, the Payer Collaborative recently launched a five-week pilot. The nine plans from the Collaborative attended a virtual check-in meeting on March 10. During the meeting, pilot participants discussed opportunities to improve the pilot survey instrument and explored areas that require clarification in order to test the feasibility and timing of the LAN’s measurement approach. Pilot participants also provided ideas about and recommended improvements to the pilot’s methodology and metrics, which will form the basis for measuring the LAN’s nationwide data collection effort. 

At the 2016 LAN Spring Summit in April, pilot participants and other Collaborative members will have the opportunity to share their commitment and experiences with other stakeholders during a plenary session. 

Additionally, plans are encouraged to join the LAN in a nationwide APM data collection effort which will begin in mid-May. It will measure APM progress towards goals of 30% APMs by 2016 and 50% by 2018 throughout commercial, Medicaid Managed Care, and Medicare Advantage market segments. 

The PBP Work Group met virtually on March 7 to discuss the draft principles developed by the Consumer and Patient Affinity Group and to review progress on the Work Group’s four sprint work products. Participants discussed preliminary recommendations from the data sharing sprint, focused on the data that providers will need to successfully manage total cost of care, quality, and outcomes for the patients for whom they are accountable. The overarching theme of the sprint’s preliminary recommendations is that for risk management under an APM to work, providers need to have access to the full array of data; providers, payers, and purchasers need to have access to cost and utilization trends; and patients need to have access to their own data. Participants also discussed preliminary recommendations from the performance measurement sprint, including the importance of evolving from the granular measures of the full continuum of care, focused on narrow and specific care processes, to more macro measures that are outcomes-oriented. Draft white papers from the data sharing and performance measurement sprints are scheduled for release next month.

The PBP Work Group received more than 70 comments from stakeholders who responded to its patient attribution and financial benchmarking white papers. The comments provided helpful guidance on a wide range of subjects, which will be incorporated into the final drafts of the white papers.