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| Calling All Health Plans |
| 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. |
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| Last Call for Comments |
| 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 |
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| Spotlight Interview – LAN Participant |
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Barry Bittman
Allegheny Health Network |
| Breaking Down Health Care Silos |
| “As industry stakeholders, we all need to realize we’re not competing with each other. In neglecting to share our insights and experiences, we’ve been wasting tremendous effort and financial resources.” |
| We recently sat down with Barry Bittman, MD, Neurologist, Senior Vice President and Chief Population Health Officer for the Allegheny Health Network (AHN), a unified health care system of seven hospitals and 300 primary and specialty care practices. In this interview, Bittman discusses developing a cost-effective, population health management strategy for AHN and highlights AHN’s perspective on alternative payment models and the LAN initiative. |
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| LAN Blog |
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Carmella Bocchino
America’s Health Insurance Plans |
| Core Quality Measures Have Value for APMs |
| In our latest guest blog, Guiding Committee member Carmella Bocchino, RN, MBA, Executive Vice President at America’s Health Insurance Plans (AHIP), and Aparna Higgins, Senior Vice President, Private Market Innovations and Director of the Center for Policy and Research at AHIP, discuss the recent release of seven core quality measure sets by the Core Quality Measures Collaborative (CQMC), an initiative to help align measures of health care quality across payers in both the private sector and public programs. Specifically, Bocchino and Higgins explain the relationship between the LAN and the CQMC, including how the LAN is incorporating some of the quality measures into its work product recommendations. |
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| Upcoming Events |
| Save the Date |
| Accountable Care: The Purchaser’s Perspective |
March 23, 2016 @ 12 – 1 pm EST |
| LAN Learnings Webinar: APMs and Geriatric Care |
April 13, 2016 @ 12 – 1 pm EST |
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| Special Session for Payers |
| March 22, 2016 @ 11 – 12:15 pm EST |
| 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. |
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| LAN Listening Session for Providers: Preliminary Recommendations on Elective Joint Replacement |
| March 22, 2016 @ 2:30 – 3:30 pm EST |
| Join us for a special listening session for providers today from 2:30 – 3:30 pm EST to discuss the draft white paper on elective joint replacement and solicit your questions and feedback. Speakers include Kevin Bozic (The University of Texas at Austin), Mark Froimson (Trinity Health), and Richard Shonk (The Health Collaborative). |
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| Accountable Care: The Purchaser’s Perspective |
| March 23, 2016 @ 12 – 1 pm EST |
| Register for a virtual presentation on Wednesday, March 23 from 12 – 1 pm EST. Purchasers are invited to join us tomorrow for a look at what innovative employers are doing to advance accountable care. Hear from expert David Lansky (Pacific Business Group on Health), who will discuss rewarding value over volume and how leading employers are directly contracting and working with carriers to implement emerging payment models. Jeff White (Boeing) will highlight Boeing’s strategy and early results in the Seattle market, while Catherine Dodd (San Francisco Health Service System) will discuss how alternative payment models are working for San Francisco employees. |
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| LAN Summit |
| Last Call for Session Submissions |
| The LAN extended its date for session submissions to Wednesday, March 23. To submit an idea for a session panel, please provide your submission on the session submission page.
Don’t miss your chance to register for the 2016 Spring LAN Summit. Visit our registration page to reserve your space today.
Wondering what to expect from the upcoming summit? Check out our archives to get a better sense of the format and sessions from the 2015 Fall LAN Summit and view highlights. Stay tuned for a new agenda coming soon. |
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| Leadership Corner |
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| Progress and Priorities for LAN Leadership |
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:
- Advance adoption of LAN-recommended Population-Based Payment (PBP) and CEP approaches though a pilot or other implementation-focused work effort
- Establish a new group focused on primary care payment models
- Establish a new group for developing better evidence on payment reform
Stay tuned for more information on each. |
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| LAN Progress |
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| Payer Collaborative Hits Halfway Point, Recruitment Begins for Nationwide APM Data Collection |
| 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. |
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| Four White Papers Underway from the Population-Based Work Group |
| 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. |
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| Of Interest |
| Visit YouTube for Past Webinar Recordings |
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| Check out the LAN’s YouTube channel to catch up on the latest webinars. Nine previous LAN presentations, including the recordings and slides, are archived on YouTube. |
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| Apply Now for NASHP’s Value-Based Payment Reform Academy |
| The National Academy for State Health Policy (NASHP) recently announced that it is convening a Value-Based Payment Reform Academy to support states in developing and implementing value-based alternative payment methodologies for federally qualified health centers and/or rural health clinics. Selected states will receive both group and individual technical assistance from NASHP staff, as well as state, federal, and national leaders over the course of twelve months. Applications will be accepted through Friday, April 1. Please contact Rachel Yalowich at ryalowich@nashp.org with any questions. |
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| Safety Net Grant Program for Providers – Applications Due April 1 |
| The National Safety Net Advancement Center (SNAC), hosted by Arizona State University with support from the Robert Wood Johnson Foundation, launched on Monday, February 22, 2016. SNAC is slated to host 6 virtual learning collaboratives and award up to 7 grants, totaling $80,000 each, to safety net providers working on payment and delivery system reform challenges. All applications are due on April 1, 2016. |
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| Recap of LAN Listening Session for Providers |
| During the LAN Listening session held on March 1, Dana Gelb Safran (PBP Work Group Co-chair), Amy Nguyen Howell (CAPG), and Hoangmai Pham (CMS) provided an overview of the draft patient attribution and financial benchmarking white papers. Questions and comments from the audience covered various topics such as financial benchmarking differences in urban and rural areas, medical coding approaches that may be used across multiple specialties, and how providers can manage patient attribution as it may change over time. |
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| Recap of Episode Bundles: Why it Matters and What Purchasers Can Do Now |
| In case you missed it, view the slides from a panel discussion on why episode bundles matter to purchasers, employers, and patients alike. This webinar took place on March 9 and was hosted by presenters Sally Welborn, SVP for Global Benefits at Walmart; Barbara Wachsman, Chair of Pacific Business Group on Health (PBGH); and Cheryl DeMars, CEO of The Alliance. Wachsman shared several episode payment recommendations, and Welborn discussed Walmart’s learnings about contracting with providers for episode bundles. Lastly, DeMars discussed her organization’s Quality Path bundled payment initiative led by several mid-size employers in the state of Wisconsin. The presenters entertained questions from participants on topics such as obstacles against employer engagement in specific episode bundle payment programs. |
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| Recap of LAN Learnings: Behavioral Health and APMs |
| The LAN hosted a webinar on March 14 to discuss the current landscape, lessons learned, and best practices in the effective integration of APMs in behavioral health settings. The webinar panelists included LAN committed partner Deborah Adler of Optum Health, who described Optum’s Achievements in Clinical Excellence program that rewards providers for collaboration, better patient outcomes, and improved cost efficiency. Don Fowls from Arizona Regional Behavioral Health Authority also spoke about reshaping the way in which providers are reimbursed for services. Henry Chung of Montefiore Health System and a LAN committed partner described Montefiore’s progress towards adopting value-based payment models. The panelists addressed comments and questions from the audience on topics such as risk arrangements and shared savings for improved outcomes in behavioral health patients with high medical service use. Other comments included how APMs may affect office-based behavioral health providers rendering outpatient care versus inpatient care. |
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