Alternative Payment Model (APM) Framework White Paper
Refreshed 2017
Report: Released July 11, 2017
Description
This white paper puts forward an alternative payment model (APM) framework that can be used to track progress on payment reform along a path that supports person-centered care. First published in January 2016 and modified in 2017 to reflect fast-moving developments in the APM landscape, the Framework establishes a common nomenclature for defining, implementing, and sharing successful payment models and has been widely adopted across the health care ecosystem. The 2017 update makes changes to Framework subcategories, clarifies payment reform goals, and identifies ways to increase APM adoption among small, rural, and safety-net providers.
Authors
Publication Info
Publication date: July 11, 2017
47 pages
Suggested Citation: Health Care Payment Learning & Action Network. Alternative Payment Models (APM) Framework.
July 11, 2017.
Table of Contents
Health Care Payment Learning & Action Network (LAN)
Overview and Introduction to the 2017 APM Framework Refresh
Overview of Changes to the APM Framework and Its Supporting Principles
The Case for Reforming the Health Care Payment System
Key Principles of the APM Framework
Fee for Service with No Link to Quality & Value (Category 1)
Fee For Service Linked to Quality & Value (Category 2)
APMs Built on Fee for Service Architecture (Category 3)
Population-Based Payment (Category 4)
Stakeholders and the APM Framework
Appendix A: Category 3 “Incentive-at-Risk” APMs
Appendix B: APM Framework Refresh Advisory Group Members and Staff
CMS Alliance to Modernize Healthcare (CAMH) Staff
Appendix C: Original APM Framework Work Group Members and Staff
Appendix E: Principles for Patient- and Family-Centered Payment
Appendix F: About the CMS Alliance to Modernize Healthcare
Blogs
Accelerating Payment Reform Through Informed and Engaged Family Physicians
by Reid Blackwelder, MD, FAAFP
Changing How we Pay for Primary Care
by Sarah Callahan, MHSA; William Golden, MD, MACP; Susan Edgman-Levitan, PA;
Ensuring the Debate has the Patient in Mind and in the Room
by Patrick Courneya, MD
Increasing Purchasing Power in Washington State
by Dorothy Teeter, MHA
Making Health Care Responsive to Patients
By Nancy Lemond, MA
Paying Providers For Value: The Path Forward
by Sam Nausbaum, MD
Paying Providers For Value: The Path Forward (Update)
by Sam Nausbaum, MD; Patrick Conway, MD, MSc; Mark McClellan, MD, PhD; Mark Smith, MD, MBA
Population-Based Payment Models: Overcoming Barriers, Accelerating Adoption
by Elizabeth Mitchell
Purchasers and Value-Based Payment: What You Can Do Now
by Sally Welborn
Why Regional Data and Local Relationships Will Reform Health Care Payment Nationally
by Elizabeth Mitchell; Dana Gelb Safran, ScD; Glenn Steele, MD, PhD
Archival Materials
Draft APM Framework Refresh paper (May 2017): Alternative Payment Model (APM) Framework
Original APM Framework paper (January 2016): Alternative Payment Model (APM) Framework
Original APM Framework One Pager (January 2016): Alternative Payment Model (APM) Framework