October 4, 2016 – eNewsletter – Health Care Payment Learning & Action Network

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NEWSLETTER | OCT. 4, 2016

{IN THIS ISSUE} Three Weeks until the LAN Summit, APM Measurement Results Coming Soon, Changing the Culture of Data Sharing

Coming Soon: Results from APM Measurement Study

This past summer, the LAN conducted a survey of health plans to measure adoption of alternative payment models (APMs) and help gauge where we stand as a nation on the pathway to payment reform. One of the largest and most comprehensive measurement efforts initiated to date, the survey assesses progress towards achieving the LAN’s goal of 30% of total U.S. health care payments in APMs by 2016. The survey will shed light on the categories of payment models that are being used across public and private health plans. Results from the survey will be announced at a special plenary at the LAN Summit on October 25, 2016. Register for the Summit to hear the results.

Shaping Recommendations for Primary Care Payment

Later this month, the Primary Care Payment Model (PCPM) Work Group will release a draft white paper outlining key recommendations on how to design and implement APMs that support primary care. Primary care currently accounts for more than 55% of the 1 billion physician’s office visits each year in the U.S., and decisions made by primary care professionals influence up to 90% of total health care costs. Yet, primary care only comprises 6-8% of commercial national health care spending, with significant challenges stemming from the fee-for-service (FFS) system that remains dominant in primary care payment. The Work Group aims to outline and address some of these challenges in its upcoming draft white paper, offering practical solutions and recommendations on the best way to pay for primary care services using APMs. Stay tuned for the release of the draft white paper on October 19.

read more about the work group

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 building data infrastructure to support APMs.

Save the Dates: Primary Care Payment Models Listening Sessions

November 2, 2016 @ 3:00 – 4:00 pm EST (Providers)
November 4, 2016 @ 1:00 – 2:00 pm EST (Payers)

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 draft primary care payment principles and recommendations developed by the Work Group. Participants will have the opportunity to ask questions and offer early feedback on this body of work.

Providers, mark your calendars for November 2, to hear Work Group co-chairs and others to provide the provider perspective on PCPMs.

Payers, mark your calendars for November 4, to hear Work Group co-chairs, Chip Howard, Judy Zerzan, and Julie Schilz share the payer perspective on PCPMs.

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.

LAN Progress

Maternity Multi-Stakeholder Action Collaborative (MAC) Seeking Implementation Partners

The LAN is pleased to announce that the number of organizations committed to participating in the MAC continues to grow.

We are still seeking additional stakeholders committed to implementing maternity care episode payment, particularly from the following states: Connecticut, Delaware, Iowa, Louisiana, Maryland, Montana, Tennessee, Virginia, and West Virginia. If you are a purchaser, commercial payer, patient organization, or provider organization in these states – or if you are a Medicaid or public employee health coverage agency in another state – and want to be involved in accelerating the development and implementation of alternative payment models for maternity care, please contact Tanya Alteras at talteras@mitre.org.

Emphasizing the Voice of Consumers and Patients

The Consumer and Patient Affinity Group (CPAG) Leadership Committee has agreed to adopt the Health Care Transformation Task Force’s new Framework for Consumer Priorities as a companion document to the CPAG’s Principles for Patient- and Family-Centered Payment, which was released in April. Similar to the CPAG principles, the Task Force’s framework offers detailed questions for APM developers and implementers to determine whether they are effectively incorporating consumer and patient principles into their models.

During their last meeting, committee members provided input on draft recommendations for the PCPM white paper and discussed the LAN’s new Maternity Action Collaborative (MAC) and Primary Care Payer Action Collaborative (PAC). To better align efforts, the LAN Work Groups and Action Collaboratives are incorporating the CPAG principles and the Task Force framework into their work. The CPAG will host a brown bag session at the LAN Summit to discuss implementation of consumer and patient principles.

Primary Care Payer Action Collaborative Begins Work on Advancing APMs

The LAN’s Primary Care Payer Action Collaborative (PAC) will kick-off on October 26, immediately following the LAN Summit. The PAC will serve as a ‘national table’ for public and private payers to come together in order to share successes and lessons learned and tackle issues and challenges related to implementing APMs that support primary care delivery transformation. LAN participants will also have an opportunity at the LAN Summit (October 25) during a PAC-oriented breakout session to share their perspectives on the PAC and learn how purchasers, patients, and providers can contribute to the advancement of primary care APMs.

Of Interest

The Culture of Data Sharing Has to Change

by Glenn Steele

In a recent Health Affairs blog, Glenn Steele, co-chair of the LAN’s Population-Based Payment Work Group, describes how an essential shift is needed in how providers, payers, and purchasers treat health data. Instead of viewing data as proprietary, the blog describes how data should be considered a public good, and outlines ways the sharing of data can support APMs.

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.