New Cardiac Care White Paper & More

The LAN is excited to announce today’s release of the draft white paper on cardiac care episode payment. We invite you to submit written comments and participate in an upcoming webinar, where you’ll have an opportunity to offer input and drive discussion on this issue. The deadline for feedback is Monday, June 20.We’re also hosting two additional webinars on maternity care episode payment and provider-led APM case studies that may be of interest. Finally, don’t forget to submit your comments for the maternity care and performance measurement white papers. Comments are due on Monday, May 23.

Taking Episode Payment Models to Heart

The draft white paper from the Clinical Episode Payment (CEP) Work Group, entitled, Accelerating and Aligning Clinical Episode Payment Models: Cardiac Care, outlines an innovative approach to designing a condition-based episode payment model for coronary artery disease (CAD). This episode includes a “nested” bundle for procedures like percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG).

The draft white paper outlines recommendations for designing a condition-based episode payment for clinicians managing the patient to more appropriately balance the needs of the patient with the number and types of services provided for CAD. This includes overall condition management designed to reduce the need for procedures, as well as the delivery of high quality procedures. The goal is to create an environment where the providers who follow cardiac patients over time actively communicate and collaborate with the surgeons who perform the cardiac procedures.

Your input is much appreciated to help us refine these recommendations and identify any key gaps or unintended consequences at the patient and system levels. Please submit your comments online, through a discussion forum on Handshake (here are some instructions), or by email (paymentnetwork@mitre.org). The deadline is Monday, June 20.

Opportunities & Challenges in Cardiac Care Episode Payments

Join the LAN on Wednesday, June 1, from 12 – 1 pm ET for an open forum webinar to discuss recommendations for an upcoming cardiac care draft white paper. Featuring CEP Work Group Chair Lew Sandy (UnitedHealth Group) and Work Group members Francois de Brantes (Health Care Incentives Improvement Institute) and Jason Wasfy (Massachusetts General Hospital Heart Center), this webinar will offer a brief overview of the LAN’s episode payment model for coronary artery disease (CAD).

Opportunities & Challenges in Maternity Care Episode Payments

The LAN invites participants to an open forum webinar on Tuesday, May 24 from 1 – 2 pm ET to collect input on the draft maternity care episode payment white paper. Featuring CEP Work Group Chair Lew Sandy (UnitedHealth Group) and Cara Osborne (Baby+Company), this will be an audience-driven, interactive forum designed to support a lively discussion across all audience members. Please attend prepared to ask questions and engage with other LAN participants on how maternity care episode-based payments can reward creating a positive, patient-centered maternity care experience, while also lowering the overall cost of maternity care. The deadline for submitting written comments on the draft white paper is Monday, May 23.

Case Studies from Provider-Led Organizations

Please register for the June LAN Learnings webinar on Monday, June 6 from 12 – 1:15 pm ET featuring case studies from provider-led organizations that are implementing APMs. Participants Heather Orth (Deaconess Health System) and Chester Ho (Indiana University Health), along with moderator Carolyn Magill (Evolent Health), will share their “do’s and don’ts” of APM contracting, care delivery improvement in complex organization environments, and effective physician engagement.

Last Call for Comments!

The public comment period for two draft white papers on maternity care and performance measurement closes on Monday, May 23. Don’t miss your last chance to submit input! Please weigh in online, through a discussion forum on Handshake (here are some instructions), or by email (paymentnetwork@mitre.org). We look forward to your thoughts and feedback.

submit comments

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.