Since 2015, the Health Care Payment Learning & Action Network has dedicated itself to providing thought leadership, strategic direction, and ongoing support to accelerate our health care system’s adoption of alternative payment models (APMs). This quarter, the LAN continued that mission through efforts including the Healthcare Resiliency Framework release and the 2020 LAN Virtual Summit. Read more below to catch up on the latest updates from the LAN team!
The COVID-19 public health emergency (PHE) has underscored the importance of resiliency in the nation’s health care system. The most effective APMs are those that deliver on quality and cost for a population, while also supporting financial stability. The APM Framework’s Category 4 (Population-Based Payment) models have shown the most promise during the PHE. Expanding the pathway to Category 4 models, as well as improving APM design in other ways – such as improving equity-focused design – will promote future health system resiliency.
The LAN launched the LAN Healthcare Resiliency Collaborative to articulate and commit to the most important short-term and long-term actions that can be taken to strengthen the health care system.
The Collaborative’s mission focuses on the following actions:
Identifying and disseminating best practices for payer supports and payer-provider collaboration to help providers recover from the impact of the PHE;
Facilitating the transition into the most effective APMs possible, as providers build on innovative care models to recover from the financial impacts of the PHE; and
Supporting further actions to identify, scale, and evolve effective APMs.
The Collaborative’s vision is to help build a health care system that more effectively responds to events such as the unprecedented PHE with a goal of improved patient experiences and outcomes, reduced disparities, and greater affordability and accessibility to quality care.
The LAN Healthcare Resiliency Framework describes key actions that payers, providers, and other stakeholder groups can take in the short-term and medium to long-term to promote more adaptable, effective APMs. The actions are interrelated, and an organization’s strategy may involve a combination of actions.
The Collaborative identified three focus areas to prioritize:
Promoting equity in health care, recognizing that resiliency is dependent on addressing root causes that contribute to poorer health outcomes for at-risk populations.
Calibrating population-based APMs to account for varying needs for capital and other non-financial supports among differing types of providers with differing levels of resources and capacity.
Advancing whole-person, person-centered care through increased clinical integration of primary and specialty care with a particular emphasis on behavioral health.
To build momentum, the LAN secured 41 commitments from a range of health care organizations – including state governments, health plans, health care providers, patient advocacy groups and large employers – to pursue many of the reforms outlined in the framework. As a demonstration of these commitments, organizations have signed onto the following statement:
“Our organization is committed to a healthcare system that is responsive and resilient to events such as the unprecedented COVID-19 public health emergency. We commit to achieving better patient experience, access, health outcomes, equity, quality, appropriateness, and affordability in the recovery from the crisis – not just a return to previous models of care and payment. In collaboration with other payers, providers, employers, and patient/consumer groups, we will lead the way through actions that help sustain and accelerate our transition to effective APMs, including those that incorporate population-based payments with prospective cash flows. In doing so, we will prioritize three resiliency areas:
Recognizing that resiliency is dependent on addressing root causes that contribute to poorer health outcomes for at-risk populations, promoting equity in healthcare through intentionality in APM design and implementation that emphasizes measurement, adequacy in payment, addressing social determinants of health, and implementing other evidence-based interventions;
Calibrating population-based APMs to account for varying needs for capital and other non-financial supports among differing types of providers with differing levels of resources and capacity, while ensuring comparable and transparent information on quality and costs at the provider level;
Advancing whole-person, person-centered care through increased clinical integration of primary, specialty, and other care into accountable primary care, with a particular emphasis on behavioral health and the use of virtual care and other novel care delivery modalities.
Our organization is committed to authentic patient and family participation in APM design and implementation.”
Thank you to all the organizations for signing the commitment and showing their support.
Some organizations have taken their commitment to the Resiliency Framework a step further by outlining and committing to specific steps their organization is taking to accelerate the percentage of U.S. health care payments in APMs. The LAN’s goal statement establishes milestones for accelerating the percentage of U.S. health care payments tied to quality and value in each market segment.
“Cigna is committed to creating a health care experience for our customers that is affordable, predictable, and simple. Our success in delivering on our mission and strategy is closely tied to the partnerships we have with our health care providers. Our commitment to value-based care is evidenced by the breadth and depth of value-based relationships that we have forged with providers across all of our lines of business and in all categories of alternate payment models (APMs). Over the past several months, the COVID-19 global public health emergency has highlighted areas of opportunity where we can further support health care providers: Helping them care for their patients, rewarding them for delivering improved health care quality, outcomes, and affordability, and providing them with greater financial stability than what fee-for-service alone can deliver, in their respective practices. Additionally, the pandemic has heightened the need for enhanced focus on the disparate health outcomes that some populations experience and on social drivers of adverse health outcomes. Cigna agrees to the ‘Shared Commitment Statement’ as proposed by the HCP-LAN Healthcare Resiliency Collaborative.
As evidence of our commitment, Cigna will:
Incorporate health disparity reduction measures in all of our APM models by 2022
Continue to promote the use of and provide adequate payment for telehealth as a channel of care delivery
Continue and expand on our existing capabilities that enable health care providers to conduct virtual peer-to-peer ‘e-consults’
Continue to expand the use of depression screening across all APMs to address behavioral health issues
Thoughtfully expand the penetration of prospective, population-based APMs.
Enhance our existing APM models to reflect the unique needs of the public health emergency, thereby ensuring that the most vulnerable populations receive the care that they need and that health care providers are supported during this time of financial uncertainty.
We at Cigna applaud the work of the HCP-LAN and are proud to be a partner in its endeavors to improve health care resiliency. The global public health emergency has accentuated key areas of opportunity in how we serve our customers and patients, and we are committed to addressing these. This is fundamental to our mission to improve the health, well-being, and peace of mind of the people we serve.”
Is your organization interested in sharing an individual commitment to support the acceleration of effective APM adoption? Contact us to find out how!
On October 14, the LAN hosted its first fully virtual event, marking the eighth annual LAN Summit. It brought together more than 930 attendees across the health care landscape to continue the conversation around value-based care and to discuss the theme of Aligning for Shared Accountability. Visit the LAN Summit Fall Virtual Event site for more information!
We extend a sincere “thank you” to all of the LAN Summit attendees for their participation and contribution to the day’s explorative and productive conversations. Additionally, we would like to express our gratitude to the speakers and plenary panelists for sharing their expertise.
The Opening Plenary featured the launch of the Healthcare Resiliency Framework and a conversation with some of our Executive Forum members who have committed to the Shared Commitment Statement. The session also included remarks by CMS Administrator Seema Verma and CMMI Director Brad Smith, who spoke to the government’s role in accelerating payment reform and the move toward value-based care.
Breakout sessions included:
The Summit concluded with A Fireside Chat: Moving Toward a Better Health Care System. This multi-stakeholder panel discussed what a post-PHE future could look like, how the LAN will continue to promote value-based health care, and considerations for future alignment toward population-based payment models.
Interested in hearing more? Check out the LAN’s whole collection of videos from the LAN 2020 Summit!
Accountable Care Learning Collaborative: New Podcast Features LAN Co-chair
CEO Forum Co-Chair Dr. Mark McClellan was featured in “Post-Election Analysis and Implications for Value-Based Care and COVID Recovery,” a new podcast episode on Race to Value, produced by the Accountable Care Learning Collaborative. Dr. McClellan discussed a wide range of topics affecting our health system, including value-based care and the HCP-LAN’s Resiliency Framework. Want to hear more about this episode? Tune in here.
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.