March 18, 2018 - eNewsletter - Health Care Payment Learning & Action Network

March 19, 2018
Posted by: Health Care Payment Learning & Action Network
Category: eNewsletter

No Comments

CONNECT

FORWARD

NEWSLETTER | March 16, 2018

Feature Story | LAN Progress | Of Interest

{IN THIS ISSUE} LAN Summit rooms available, JAMA Viewpoint article released, PAC to delve into CPC+ Operational Solutions, Maternity Care Episode Roadmap coming soon, New reports from HCTTF and SVHS

Book Your Travel for the 2018 LAN Summit

The 2018 Health Care Payment Learning and Action Network (LAN) Fall Summit is scheduled for Monday, October 22, 2018, at the Sheraton Tysons Hotel in Tysons, Virginia. The 2018 Summit will continue to build on the momentum of the LAN by bringing together stakeholders from across the health care system to transform payment in a way that emphasizes quality over volume. The Summit will feature leaders and innovators in health care as speakers in plenary and break-out sessions throughout the day, including the following:

Industry leaders discussing an array of innovations in payment reform, touching on implementation methods and lessons learned;
Federal and state health care purchasers describing how they are addressing the current and future health care delivery challenges via new payment models that put the patient first; and
LAN Summit attendees collaborating in facilitated workshops designed for specific stakeholder groups focusing on vital areas of interest – and challenges — surrounding design and implementation of APMs.

Registration will open this summer and be announced via email and social media. Discounted hotel rates at the Sheraton Tysons Hotel are available through our room block. Reserve your room today!

JAMA Publishes Article Outlining
APM Principles

On February 20, 2018, the Journal of the American Medical Association published an article authored by LAN contributors titled Principles for a Framework for Alternative Payment Models. This article highlights the LAN’s APM Framework that was refreshed in 2017 and outlines three major themes in the framework’s foundational principles:

Patient protections against updated economic incentives for providers;
Health care professional protections against undue risk; and
Value-based goals for payment reform

The APM Framework White Paper was initially developed in January 2016 and updated in July 2017 by a multi-stakeholder Advisory Group led by Sam Nussbaum, M.D. (University of Southern California Shaeffer Center). The refreshed paper provides updates to categories, clarifies payment reform goals, and identifies ways to increase APM adoption.

The APM Framework has been used to guide an annual measurement effort to assess the progress of APM adoption against the LAN’s goal of having 50% of all health care payments in the U.S. linked to quality and value through APMs by 2018. The most recent measurement effort, conducted from June to August 2017, surveyed and collected data from over 80 plans and payers, accounting for nearly 245.4 million Americans, or 84% of the covered U.S. population, up from 67% in the previous year. The latest report shows progress with 29% of total U.S. health care payments tied to alternative payment models (APMs) in 2016 compared to 23% in 2015, a 6 percentage point increase in the adoption of APMs.

LAN Progress

Payer Collaborative Extended to Continue Focus
on CPC+ Track 2

The LAN’s Primary Care Payer Action Collaborative (PAC) continues to support commercial and public payers participating in Comprehensive Primary Care Plus (CPC+) by bringing payers together to share learnings and solutions as they implement alternative to fee-for-service payments to physician practices in Track 2 of the model. A Centers for Medicare & Medicaid Services initiative, CPC+ is a regionally based, multi-payer advanced primary care model operating in 18 regions.

The PAC’s current series of interactive webinars kicked off in February with a session on risk adjustment and financial reconciliation. During this session, Independent Health provided an overview of its Primary Value Model, which launched in January 2018 with approximately 130 practices. It aims to transition eligible practices from fee-for-service (FFS) to value based reimbursement and reward primary care providers for providing value. The second session in the series addressed specific aspects of constructing an alternative to FFS payment, during which Capital District Physicians’ Health Plan (CDPHP) provided an overview of its Enhanced Primary Care model, a patient-centered medical home (PCMH) model that offers increased value for members and financial rewards for physicians. As part of a deeper dive on operations, the PAC’s other virtual sessions in 2018 include designing payment to support advanced team-based care at the practice site, Medicaid-specific alignment opportunities, and reconfiguring claims processing systems to enable alternative payments. You can access summaries, slides, and other materials from these and earlier PAC activities on the public PAC Portal as they become available.

For questions about the PAC, please contact Jennifer Sulkin, PAC staff lead.

Coming Soon: New Maternity Episode Care
Roadmap for State Action

The LAN will soon be releasing the Maternity Episode Care Roadmap for State Action. This product highlights the ways in which two states – Ohio and Tennessee – established their maternity episode payment models for their Medicaid populations. Both states received State Innovation Model (SIM) grant funding, which was used to design and launch their episode models. This report also includes information about the considerations that drove various high-level decision points. The road map is a part of the Maternity Episode Payment Model Online Resource Bank, which includes issue briefs, infographics, and resources from the Maternity Care Action Collaborative (MAC) meetings that were convened by the LAN last year.

Of Interest

New Reports from HCTTF Examine Value-Based Care and the Success of ACOs

The Health Care Transformation Task Force (HCTTF) partnered with New England Jorunal of Medicine Catalyst to offer an unprecedented look at how value-based care has positively disrupted the U.S. health care economy. The Economic Investment and the Journey to Value resource is a series of reports which detail how value has impacted patients, providers, payers, purchasers, and partner organizations across the nation.

HCTTF also recently released the Levers of Successful ACOs report, which features interviews from high-performing Accountable Care Organizations (ACOs) to assess structures and strategies that led to their success. Although each organization had differing approaches and experiences, common themes emerged in three major categories: 1) Achieving High-Value Culture, 2) Proactive Population Health Management, and 3) Structures for Continuous Improvement.

State Health Policy Briefs Feature the LAN APM Framework

The State Health & Value Strategies program recently released two issue briefs which highlight ways in which state purchasers are using the Health Care Payment and Learning Action Network (LAN) Alternative Payment Models (APM) Framework when measuring and assessing health plan progress towards APM requirements. The first issue brief in the series, Categorizing Value-Based Payment Models According to the LAN Alternative Payment Model Framework: Examples of Payment Models by Category, provides real-world examples of APMs within the LAN framework categories and can help states and other interested purchasers develop a common understanding of what types of payment models fit within the each category.

The second brief, State Medicaid Approaches for Defining and Tracking Managed Care Organizations Implementation of Alternative Payment Models, focuses on the different ways states may set standard APM definitions to a) track MCO progress toward meeting state APM goals, and b) support comparison of APM implementation within a state and nationally.

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.

Author: Health Care Payment Learning & Action Network

March 18, 2018 – eNewsletter

Health Care Payment Learning & Action Network

Leave a Reply Cancel reply