2022 Measurement Effort

The LAN launched the 2022 Measurement Effort to collect 2021 APM data on May 23, 2022 and the data collection period concluded on July 30, 2022.
All seven LAN APM Measurement Efforts requested health plans and states to provide retrospective data of actual dollars paid to providers during the previous calendar year (CY) or the most recent 12-month period for which the data was available.

A total of 63 health plans, five FFS Medicaid states, and Traditional Medicare participated in the 2022 Measurement Effort, representing approximately 233,870,081 of the nation’s covered lives and 77.7% of the national market. The percentage of the national market is based on a denominator of approximately 300,887,000 lives covered by any health insurance plan. More information on 2022 payment results can be found https://hcp-lan.org/apm-measurement-effort/2022-apm/.

The results demonstrated the following for payments made during CY 2021:

  • 40.5% of healthcare dollars in Category 1
  • 19.5% of healthcare dollars in Category 2
  • 32.6% of healthcare dollars in Category 3
  • 7.4% of healthcare dollars in Category 4

Publication Info

Publication date: November 9, 2022

34 pages

Suggested Citation: Health Care Payment Learning & Action Network. Measuring Progress: Adoption of Alternative Payment Models in Commercial, Medicaid, Medicare Advantage, and Traditional Medicare Programs. November 9, 2022

The HCP-LAN invited health plans across market segments, as well as managed Medicaid FFS states, to quantify the volume of health plan in- and out-of-network spending that flows through APMs, including key areas of available pharmacy and behavioral health spending, if such data were available. Each of the questions in the survey corresponded to the categories and subcategories of the LAN’s Refreshed APM Framework, using the LAN survey tool, definitions, and methodology.

In this year’s effort, 63 health plans, 5 Medicaid FFS states, and Traditional Medicare participated; the measurement results were based on data combined across the LAN survey, the BCBSA survey, the AHIP survey, and Traditional Medicare. Health plans, states, and Traditional Medicare reported the total dollars paid to providers according to the LAN’s Refreshed APM Framework using the same survey questions and definitions. With this data, the LAN calculated aggregate results at the category and subcategory level as well as across lines of business.

For more information on the methodology, please read the Methodology and Results Report above.