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| LAN Summit Agenda Available |
| The LAN is excited to release an interactive program agenda for the upcoming 2016 Spring LAN Summit, which includes detailed session descriptions and speaker information. With more than 500 innovators already registered to attend, the LAN Summit will offer over 40 plenary and breakout sessions, including sessions featuring Work Group recommendations. The event also includes a special listening session on primary care, a session on the new Payment Reform Evaluation Hub, feedback from the Payer Collaborative measurement pilot, and a plenary focused on how the CMS Transforming Clinical Practice Initiative (TCPI) is helping prepare the health care delivery system for new payment models.
Registration for the LAN Summit is free and we encourage all participants to reserve their spaces soon. |
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| Health Plans Wanted |
| In mid-May, the LAN will launch an eight-week nationwide data collection program with public and private health plans that will conclude in mid-July. To gain an accurate picture of APM adoption nationwide, the LAN is recruiting 200–300 public and private health plans across the country to participate in this effort. The results will help the LAN assess progress towards the goal of shifting 50% of U.S. health care payment to APMs by 2018.
Email paymentnetwork@mitre.org to indicate interest in joining other leading health plans in this critical effort to gauge where we stand as a nation on the pathway to payment reform. |
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| Coming up this Month: Draft White Papers |
| Later this month, the LAN’s Clinical Episode Payment (CEP) Work Group will release a new draft white paper for public comment, which will provide draft recommendations on designing episode payment that will incentivize the delivery of high-quality maternity care. The draft paper will look at a maternity care episode as encompassing prenatal care, labor and birth, and postpartum care. In this way, episode payment will seek to address current gaps across the continuum of care.
Also later in the month, the Population-Based Payment (PBP) Work Group will release a new draft white paper addressing performance measurement. 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 in payment can support delivery system transformations that improve patient care and outcomes at lower costs. Specifically, it will present how to evolve from granular measurement systems of the full continuum of care, which focus on narrow and specific care processes, to more macro-level measurement systems oriented on outcomes.
Stay tuned for invitations to comment on both draft papers once the comment periods open in mid-April. |
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| New Payment Reform Evaluation Hub Launched |
| The LAN is excited to announce the launch of a new activity, the Payment Reform Evaluation Hub, a national collaborative that will work to identify and develop specific short-term steps for evaluations that are transparent, fast, inexpensive, and reliable.
The Hub will use current best practices in evaluation to address key barriers to more efficient evaluation of payment reforms, aiming for practical steps and support tools that can be maintained by purchasers, used by evaluators, and implemented by a wide range of organizations to enable more effective evaluations.
Operating under the umbrella of the LAN, the Hub will work in collaboration with the Duke-Margolis Center for Health Policy and the Laura and John Arnold Foundation to develop recommendations and tools and find practical evaluation opportunities. Stay tuned for more information about how to engage. |
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| Upcoming Events |
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| LAN Learnings April: Home-Based and Other Geriatric Medical Homes for the Elderly |
| April 13, 2016 @ 12 – 1:15 pm EST |
| Join our upcoming LAN Learnings webinar on Wednesday, April 13 from 12 – 1:15 pm EST. This virtual presentation and discussion will highlight effective APMs for the delivery of care to one of our country’s most vulnerable populations: the elderly. Hear from prominent geriatricians who will share their experiences and discuss lessons learned for implementing innovative payment models effectively. Hosted by LAN Guiding Committee member Tom Buckingham, panel members include Eric De Jonge (MedStar Washington Hospital Center), Steve Phillips (Sanford Center for Aging, University of Nevada), and Alan Lazaroff (Geriatric Medicine Associates & St. Anthony Hospital). |
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| Guiding Committee Weighs in on Population-Based Payments |
| The Guiding Committee (GC) held its monthly teleconference on Tuesday, March 29. The purpose of the meeting was to provide feedback on the PBP Work Group’s draft performance measurement white paper. The Work Group is focusing on recommendations for measurement systems that could be applied to categories 3 (APMs that are built on FFS architecture but share savings and risk) and 4 (population-based payment models) in the APM Framework where providers agree to assume accountability for a population across a full spectrum of care. The GC requested that the Work Group develop more guidance on steps that could be taken by stakeholders in the next 12-24 months to help accelerate the adoption of PBP models. The GC also encouraged the Work Group to broaden the focus of the paper to give more careful consideration to the concerns of purchasers, consumers, and patients and uses for performance measurement within PBP models. |
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| LAN News |
| New Slide Library Available to LAN Participants |
| We just released a new LAN roadshow slide library which provides an overview of the LAN, its goals, activities, and products. If you would like to use the LAN slide library for presentations, please contact HCP-LAN Support. |
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| Follow us on Twitter! |
| We’re ramping up our social media efforts with regular posts and updates. We invite all participants to stay active with the LAN, get real-time updates, and engage with us. Please follow us on Twitter and join our LinkedIn group so that you don’t miss any updates or important announcements. |
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| Of Interest |
| Arkansas Making Strides in Payment Reform |
| A recent story in the Los Angeles Times highlights the sweeping changes Arkansas is taking to expand its Medicaid program and innovate its approach towards payment reform. The results are impressive: lower health care costs, fewer unnecessary tests, better patient outcomes, and fewer hospital readmissions. |
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| CAPG Symposium on April 22 |
| Don’t miss the upcoming CAPG April Symposium, How to Thrive in Risk-based Coordinated Care, on Friday, April 22 from 9 am – 4 pm in Chicago, Illinois. For more information on sessions and registration please visit www.capg.org.
This event is part of CAPG’s 2016 educational series, which includes symposiums and quarterly webinars on specific topics addressing value-based payment models to help empower organizations in their transition to APMs. |
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| MACRA & APMs |
| Have questions about the Medicare Access & CHIP Reauthorization Act (MACRA)? Visit the FAQs page on the CMS website to learn more about the legislation, the programs, how they work, what they mean for payment reform, and to view a host of other helpful resources. |
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| What We’re Reading |
| In a recent Health Affairs blog, CEP Work Group member John Bertko offers a unique perspective on risk adjustment, based on his experience as a health insurance actuary. The blog delves into what risk adjustment is, how it works, what’s required, and what the outlook is so far in the context of the Affordable Care Act (ACA). |
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| Recap of Accountable Care: The Purchaser’s Perspective |
| LAN members recently participated in a webinar discussion on March 23 to gain purchaser perspectives on ACO strategies. During this presentation, David Lansky, LAN Guiding Committee member and CEO at the Pacific Business Group on Health, discussed the important elements of ACO design and purchaser perspectives on the current ACO market. Jeff White, Director of Health Care Strategy and Policy at The Boeing Company, then discussed Boeing’s health care profile, direct ACO contracting model and plan structure, and lessons learned. Lastly, David Lansky shared lessons learned and success metrics of major employers in the San Francisco Health Care System that are engaged with ACOs. The presenters addressed questions and comments from the audience on topics such as employer requirements to integrate primary care, behavioral health care, specialized care management for high-cost, high-need plan members, contracting mechanisms with ACOs, and communications among managed care organizations, providers, and employees receiving care through ACOs. |
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| Recap of LAN Listening Session for Payers: Preliminary Recommendations on Elective Joint Replacement |
| On March 22, the LAN hosted a listening session for payers to discuss the LAN’s episode design recommendations and gather payer perspectives on clinical episode payment models for elective joint replacement. Lewis Sandy highlighted the CEP Work Group’s draft elective joint replacement white paper. The audience posed comments and questions to the panel such as how the health IT vendor community can be utilized to help administer both prospective and retrospective bundles and how cost transparency for patients can align with retrospective reconciliation models. |
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| Recap of LAN Listening Session for Providers: Preliminary Recommendations on Elective Joint Replacement |
| The LAN held a listening session for providers on March 22 to share and discuss the LAN’s preliminary recommendations on clinical episode payment models for elective joint replacement. Richard Shonk, CEP Work Group member and Chief Medical Officer for The Health Collaborative, provided an overview of the CEP Work Group’s charge and discussed the Work Group’s episode payment recommendations for elective joint replacement. Kevin Bozic, CEP Work Group member and Chair of Surgery and Perioperative Care at the University of Texas at Austin’s Dell Medical School, discussed the use of patient-reported outcome measures in joint replacement procedures. Lastly, Mark Froimson, CEP Work Group member and Executive Vice President and Chief Clinical Officer at Trinity Health, discussed his organization’s strategy for implementing episode-based payments. The panel addressed questions from providers, including whether the preliminary focus on elective joint replacement in clinical settings should be to assess the medical necessity of joint replacement or to control its post-acute care costs. Other comments focused on including anesthesia care considerations in the draft white paper as well as identifying the best use of validated tools such as PRO measures. |
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| Recap of LAN Listening Session for States: Preliminary Recommendations on Elective Joint Replacement |
| On March 17, the LAN hosted a special listening session for states. The panel highlighted the CEP Work Group’s draft elective joint replacement white paper. John Bertko, CEP Work Group member and Chief Actuary of Covered California, discussed the clinical episode recommendations for elective joint replacement, and Steve Spaulding, CEP Work Group member and Senior Vice President of Enterprise Networks at Arkansas Blue Cross Blue Shield, provided a state-level overview of the Arkansas Health Care Payment Improvement Initiative. Lastly, Brooks Daverman, CEP Work Group member and Director of Strategic Planning and Innovation for the State of Tennessee, provided a state-level overview of the Tennessee Health Care Innovation Initiative. |
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