April 19, 2016 – eNewsletter – Health Care Payment Learning & Action Network

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APR. 19, 2016

Feature Stories | LAN Blog | Leadership Corner | LAN Progress
Of Interest | Worth Another Look

{IN THIS ISSUE} Last Chance to Register for the LAN Summit, Upcoming White Papers, Health Affairs Spotlights Measurement Effort

LAN Summit is Next Week!

Don’t miss your last chance to register for the upcoming 2016 Spring LAN Summit April 25-26 in Tysons, Virginia. If you’re a health care payer, purchaser, provider, consumer or patient advocate, state or national government official, or someone who supports them, please join us as we work to accelerate the adoption of alternative payment models (APMs) for improving health care.

We’ve pulled together an exciting two-day agenda that covers more than 40 plenaries and sessions on designing and implementing APMs, featuring leading experts and diverse perspectives from the field, including keynote speaker Patrick Conway (Centers for Medicare & Medicaid Services). As part of the Summit, we’re also hosting an exclusive “Meet the Experts” session to give participants a unique chance to speak with a LAN Guiding Committee or Work Group member and ask specific questions about APM adoption and implementation. Finally, the LAN is organizing a networking event on the first evening of the Summit and encourages participants to attend. We invite you to join hundreds of other innovators at this important stakeholder event. For more information, read our latest blog to learn who should attend, what to expect, and how to participate.

This Friday: Maternity Care & Performance Measurement White Papers

On Friday, April 22 the Clinical Episode Payment (CEP) Work Group will release a new draft white paper highlighting recommendations for designing episode payment to incentivize the delivery of high-quality maternity care. Focusing on maternity care episode as encompassing prenatal care, labor and birth, and postpartum care, the draft paper addresses current gaps across the continuum of care.

The Population-Based Payment (PBP) Work Group will also release a new draft white paper on Friday, April 22, which addresses performance measurement to enable PBP models. The paper will offer both short-term action recommendations and a longer-term vision for accelerating alignment around APMs. In addition, the paper will recommend ways to design and implement measurement systems in PBP models so that their use can support delivery system transformations that improve patient care and outcomes at lower costs.

Beginning this Friday, participants may offer comments and input on both draft white papers online, through Handshake, or by email.

LAN Blog

Sam Nussbaum

Health Affairs Spotlights National APM Data Collection

Today, Health Affairs featured an updated blog from Guiding Committee members Sam Nussbaum (formerly of Anthem), Patrick Conway (CMS), Mark McClellan (Duke University), and Mark Smith (University of California, Berkeley and University of California, San Francisco), which invites all health plans to join the upcoming nationwide APM progress tracking effort beginning in May. Those who participate will play a key role in advancing our understanding of the depth and breadth of payment innovation alongside many of the larger health plans that have already joined this critical effort.

Leadership Corner

LAN Guiding Committee Focuses on Implementation of Recommendations, Primary Care

In its second in-person meeting of 2016, the LAN Guiding Committee (GC) celebrated the completion of its first year and discussed next steps for extending the impact of the LAN in year two. The GC agreed that developing ways to help public and private stakeholders implement Work Group recommendations is crucial to ensuring widespread adoption and use of APMs. In addition, the GC discussed how a new Work Group focused on primary care can create opportunities for more primary care professionals to learn how to operate within Categories 3 and 4 of the APM Framework. The Consumer and Patients Affinity Group (CPAG) presented a set of draft guiding principles which the GC discussed, provided feedback on, and agreed to endorse. Feedback was also provided to the CEP and PBP Work Groups about how to continue to develop the recommendations in their next draft papers which will be released for public comments. Both the draft performance measurement and the draft maternity care white papers will be released on Friday, April 22 and will be available on the LAN website. All stakeholders are encouraged to read the papers and provide feedback and comments.

LAN Progress

Progress on Four Population-Based Payment White Papers

The Population-Based Payment (PBP) Work Group plans to release the final draft patient attribution and financial benchmarking white papers in May. The papers will reflect feedback from the public comment period that closed March 7. The updated papers will address themes from the comments, while offering actionable recommendations that will guide stakeholders in their adoption of APMs.

Additionally, the Work Group is in the final stages of completing the draft of a white paper focused on performance measurement for PBP models, which will be released for public comment on Friday, April 22. The group is also developing the fourth and final PBP white paper that addresses data sharing. Data is necessary to inform and support health care stakeholders and is critical to the success of measuring performance. Together, these four PBP white papers address priority issues that are foundational for the success of PBP models.

Developing Recommendations for Maternity & Cardiac Care

The Clinical Episode Payment (CEP) Work Group continues to develop recommendations for episode payment models for maternity care and coronary artery disease (CAD). On April 4, the Work Group discussed how to appropriately convey the perspectives of patients, consumers, payers, providers, purchasers, and states. The Work Group also discussed what considerations stakeholders need to be cognizant of when developing data infrastructure for maternity and cardiac episode payments, as well as what regulatory issues may arise in the development and implementation of such models. The draft white paper on maternity care will be released for public comment on Friday, April 22.

An Opportunity for Health Plan Payers

The LAN will launch an eight-week nationwide data collection effort with public and private health plans next month to gauge the nation’s progress in adopting Category 3 and 4 APMs. The LAN is recruiting 200 – 300 public and private health plans nationwide to participate in this effort. Read a recent blog from Health Affairs that also highlights this issue.

Join this expanding group of participants – and demonstrate your leadership in APM adoption. To participate in the effort, send an email to paymentnetwork@mitre.org.

Of Interest

JAMA Highlights New Payer Opportunity in Primary Care

A recent story from the Journal of the American Medical Association (JAMA) highlights a new opportunity for multi-payer alignment to transform primary care through Medicare. Comprehensive Primary Care Plus (CPC+), a new advanced primary care medical home model launched by the Centers for Medicare & Medicaid Services (CMS), represents the largest investment in primary care transformation to date. Partnering with commercial and state payers in up to 20 regions across the country, CPC+ will strengthen both health care delivery and APMs, rewarding value and quality through an innovative payment structure that supports comprehensive primary care. Designed as a five-year model, CPC+ is scheduled to begin in January 2017.

From April 15 – June 1 CMS will solicit payer proposals to participate in CPC+. Based on payer interest and coverage, it will announce the CPC+ regions in July 2016, and request applications from eligible practices within these geographic locales from July 15 – September 1.

Utah Regional Health Care Innovation Day on April 27

The Utah Regional Health Care Innovation Day will bring together health care professionals, payers, health care organizations, and state and federal government officials to discuss innovations to transform health care. During this event, those working locally to improve health, provide care, and lower costs through innovative strategies will share their vision, lessons learned, and results.

Health Care Payment Learning & Action Network

To achieve the goal of better care, smarter spending, and healthier people, the U.S. health care system must substantially reform its payment structure to incentivize quality, health outcomes, and value over volume. The Health Care Payment Learning and Action Network (LAN) was established as a collaborative network of public and private stakeholders, including health plans, providers, patients, employers, consumers, states, federal agencies, and other partners within the health care community.