Commercial health plans, Managed Care Organizations (MCOs), state Medicaid agencies, Medicare Advantage (MA) plans, and Medicare voluntarily participated in a national effort to measure the use of Alternative Payment Models (APMs) as well as progress towards the LAN’s goal of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018.
40.9% of U.S. health care payments, representing approximately 238.8 million Americans and 80.2% of the covered population, flowed through Categories 3&4 models. In each market, Categories 3&4 payments accounted for:
TRENDS OVER TIME
Since its inception in 2015, the LAN has measured the amount of U.S. health care payments that flow through alternative payment models (APMs). Over time, the LAN refined its measurement process to examine APM adoption by line of business (LOB) and payments by subcategory within the four categories of the LAN’s Refreshed APM Framework.
The line graph shows how APM spending in Categories 3 and 4 changed year-over-year by LOB. The bar graph illustrates the adoption of two-sided risk APMs (Categories 3B, 4A, 4B, 4C) by line of business since 2018. Click below to view the graphs.
SUMMARY STATISTIC STATEMENTS FOR INFORMATIONAL QUESTIONS
(2018-2021 Measurement Effort Years, 2017-2020 Data Years)
Click the image to the right to see results for the past four years.