September 14, 2016 – eNewsletter – Health Care Payment Learning & Action Network

CONNECT

FORWARD

NEWSLETTER | SEP. 14, 2016

Feature Story | Upcoming Events | LAN Summit
LAN Progress | Of Interest

{IN THIS ISSUE} Missed Our Twitter Chat? Check it out on Storify, Clinical Episode Payment Fact Sheets Now Available, Register for the October LAN Learnings

#PCPMChat Storify Recap

On August 25th, the LAN successfully hosted its first ever Twitter chat. Led by the Primary Care Payment Model (PCPM) Work Group co-chairs, Bill Golden and Susan Edgman-Levitan, the chat engaged LAN participants on their experiences transitioning to alterative primary care payment models. Comments were shared with the PCPM Work Group and are being incorporated into the Work Group’s primary care payment draft principles and recommendations.

As a quick summary, chat participants supported using prospective payment to incentivize greater use of non-visit interactions (i.e., broadening options beyond traditional office visits). The chat also highlighted critical areas that need to be addressed, including concerns about whether primary care payment models will work well for small and rural practices and what kind of support would be necessary for those smaller practices to move to alternative primary care payment models. In addition, chat participants raised concerns about how swiftly change could successfully occur and whether these new payment models would be attractive to all practices, not just early adopters.

Driving Improvements in Primary Care Payment

The LAN recently spoke with Rishi Manchanda, chief medical officer of The Wonderful Company and member of the PCPM Work Group, to offer a purchaser perspective on how cultivating primary care delivery best practices can drive value and improve health outcomes. In this interview, Manchanda also shares his vision for ensuring providers are empowered to make smart decisions when it comes to writing prescriptions, making referrals, and ordering tests. This interview is the second in a short series that explores the role primary care payment can play in health care payment reform efforts:

Q: As a purchaser, what impact do you hope the PCPM Work Group will achieve in helping the LAN reach its goal of moving 30% of U.S. health care payments into APMs by the end of 2016, and 50% by the end of 2018?

My hope is that the PCPM work will help pave the way to achieving the LAN’s goals by helping primary care providers and purchasers better define “value.” Among other efforts, this means enumerating the key functions that “best-in-class” care delivery models can use to drive better outcomes and value (e.g., demonstrated ability to consider cost, quality and value in clinical decision-making in the spirit of “choosing wisely.”)

Upcoming Events

Success Stories: Building a Robust Data Infrastructure that Supports APMs

October 5, 2016 @ 2:00 – 3:15 pm EST

Join us for this LAN Learnings webinar that will highlight how two organizations have used different data sharing infrastructure approaches in their market areas and have provided benefits to multiple stakeholders, including payers, providers, and purchasers. Guiding Committee member Elizabeth Mitchell will host panelists David Kendrick of MyHealth Access Network of Tulsa, Oklahoma and Mylia Christensen of Oregon Health Care Quality Corporation as they address partnerships established, barriers overcome, sources of funding, lessons learned, and examples of data available to the various stakeholders. Join us to learn about these promising practices in data sharing.

Save the Dates: Primary Care Payment Models Listening Sessions

November 2, 2016 @ 3:00 – 4:00 pm EST and
November 4, 2016 @ 1:00 – 2:00 pm EST

Please mark your calendars and join the LAN for one of two upcoming listening sessions about alternative payment models for primary care. During these webinars, the LAN’s Primary Care Payment Model (PCPM) Work Group co-chairs Susan Edgman-Levitan and Bill Golden will provide an overview of the principles and draft recommendations developed by the Work Group. Participants will have the opportunity to ask questions and offer early feedback on the draft recommendations.

The PCPM Work Group is committed to including a range of diverse viewpoints on primary care payment models across the health care system. All perspectives and comments shared during these webinars will help refine the final PCPM recommendations. Currently, the release date for those recommendations is early February 2017.

Learn more

LAN Progress

LAN Committed Partners Milestone

The LAN is thrilled to announce that we have reached 100 Committed Partners! This milestone demonstrates the growing momentum of APM adoption. Share how your organization supports the LAN’s goals and become a LAN Committed Partner today.

Updates on the Action Collaboratives to Drive Implementation of APMs

In its first year, the LAN focused on developing consensus guidelines for alignment of APMs. With the recent release of a suite of white papers from the Population-Based Payment (PBP) and Clinical Episode Payment (CEP) Work Groups, the activities of the LAN are increasingly shifting to implementation and action. The new Maternity Multi-Stakeholder Action Collaborative (MAC) and the Primary Care Payer Action Collaborative (PAC) will increase adoption of APMs by bringing together participants who are committed to accelerating the adoption and sustainability of APMs. The MAC and PAC will provide those participants with opportunities for collaborative conversations, small group consultations with subject matter experts, and other ways to learn from their peers so they are better-positioned to effectively develop and implement episode payments for maternity and primary care.

The PAC’s first in-person kick off meeting will take place in McLean, VA on October 26. The MAC’s in-person kick off meeting will be scheduled soon. In the meantime, stay up to date on the latest information and learn more about how you and your organization can participate. If you have questions, please contact Tanya Alteras at talteras@mitre.org.

Of Interest

New CEP Fact Sheets Available

In case you missed it, last month the LAN released the Clinical Episode Payment (CEP) White Paper entitled, Accelerating and Aligning Clinical Episode Payment Models. The paper highlights both design and operational considerations and offers a high-level roadmap for developing episode payment models while leaving enough flexibility to allow for implementation that is tailored to local markets. More recently, the LAN released fact sheets and FAQs to accompany the paper and to serve as resources for stakeholders working on models for elective joint replacement, maternity care, and coronary artery disease. Check out the new fact sheets highlighting key elements from the CEP paper:

Highlighting Consumer Priorities in Consensus Framework

The Health Care Transformation Task Force (HCTTF) released a new framework entitled, Addressing Consumer Priorities in Value-Based Care: Guiding Principles and Key Questions. This paper addresses consumer priorities in value-based care. It is organized around six broad principles and poses 130 questions that systems can use to promote dialogue and action.

Catalyst for Payment Reform Virtual Summit

Join Catalyst for Payment Reform (CPR) on September 20 from 11 am – 1 pm EST for an online learning opportunity focused on aligning provider payments and employee benefits. The virtual summit will include case studies from Boeing and Intel Corporation, and will feature a virtual panel of health care thought leaders, including Lisa Woods, a LAN Work Group member. The panel will describe how the right combination of provider payment methods and benefit designs could significantly push the health care system to deliver greater value.

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.