The movement to tie payments to quality is happening through collective effort and the leadership of a wide variety of organizations. LAN Committed Partners are organizations that support the implementation of LAN recommendations, establish their own goals and activities in support of APM adoption, share these with the LAN.
Categories include organizations that operate in that category as well as those that represent or service them. Organizations may fall into more than one category.

Academy of Nutrition and Dietetics
Commitment Statement:
The Academy of Nutrition and Dietetics, representing more than 100,000 registered dietitian nutritionists (RDNs), nutrition and dietetic technicians, registered (NDTRs), and advanced-degree nutritionists, is the largest association of food and nutrition professionals in the United States and is committed to improving health through food and nutrition across the life cycle.The Academy commits to accelerating the adoption of Alternative Payment Models by preparing and engaging a workforce that will provide patient-centered cost-effective care and add value for all stakeholders engaged in an Alternative Payment Model environment. The Academy will:
- Leverage the LAN and its partners and industry resources to develop customized education for RDNs including toolkits, webinars, face-to-face learning, the Journal of the Academy of Nutrition and Dietetics, and web-based content to increase the knowledge of seasoned professionals and those in training who will add value in organizations adopting Category 3 and 4 APMs.
- Offer “technical assistance” to LAN partners testing Clinical Episode or Population-Based Payments where stakeholders want to include evidence-based nutrition care in the design.
- Share its Patient-Centered Nutrition Services framework with LAN participants seeking to estimate the total cost of care throughout the continuum of care in chronic disease prevention and management.
Website:

ACAP
Commitment Statement:
ACAP is committed to accelerate the adoption of value-based payment strategies, including Category 3 and 4 alternative payment models, by Safety Net Health Plans. This will be done by conducting a series of educational webinars, plan-to-plan networking and encouraging ACAP member plans to participate in the LAN National APM Data Collection effort.
Website:

Accountable Care Learning Collaborative
Commitment Statement:
The mission of the Accountable Care Learning Collaborative is to support providers in successfully transitioning to value-based payments as described in Categories 2-4 of the APM Framework. Through collaborative workgroups, more than seventy member organizations including providers, payers, associations, manufacturers and others are identifying the necessary care delivery competencies that risk-bearing provider entities need to succeed. Additionally, the ACLC will serve as a center for providers to find support resources that will enable them to develop these competencies. All of the ACLC products will be publicly released to support the industry in transitioning to value-based care.
In 2016, the ACLC will release its first publication of essential competencies, followed by subsequent publications as the industry continually learns.
In 2017, the ACLC will create a resource center for providers seeking to improve in care delivery.
Website:

Advisory Board
Commitment Statement:
Advisory Board commits to providing continuing support to our 4,400 health care member organizations as they adopt new payment models and improve care delivery. We will continue to forge and find best practices that enable organizations to successfully navigate this transformation, including under Category 3 and 4 alternative payment models. Through our relationship as a trusted advisor, we will disseminate our insights and deliver critical technology and consulting services. Our ongoing commitment includes national meetings attended by senior leaders of health care organizations. At these meetings, we discuss industry trends and best practices including frequent guidance with regard to alternative payment models offered by both public and private payers.
Website:

Aetna
Commitment Statement:
Aetna has been moving toward value-based contracting models for more than eight years. Our goal is to have 75% of our medical claims payments under value-based designs by 2020 and we are on target to have 55% in value-based designs in 2018. This includes many value-based payment models including Accountable Care Organizations, Patient Centered Medical Homes, High Performance Networks, Medicare Collaboratives, Capitation and Bundled Payment Arrangements. We are working to ensure that an increasing portion of our payments are in more advanced models (Categories 3 and 4) as we move forward.
Website:
Media:

Alliance of Community Health Plans
Commitment Statement:
More than 50% of ACHP members have implemented APMs for at least half of their physician networks by end of 2016.
The Alliance of Community Health Plans (ACHP) is pleased to participate in the Health Care Payment Learning and Action Network, an ambitious Department of Health and Human Services initiative to move Medicare and the entire health care system toward payment based on quality rather than quantity.
ACHP joins other organizations that support national alternative payment model goals for the U.S. health system that match or exceed the Medicare goals of 30 percent alternative payment model penetration by 2016 and 50 percent by 2018; agree that the progress toward national goals should be measured; and work with network participants to establish standard definitions for alternative payment models.
“ACHP is excited to be part of the national movement toward value-based payment,” says ACHP President and CEO Patricia Smith. “Community-based health plans have experienced the results of alternative payment models first-hand: Increased physician engagement, lowered costs and improved patient experiences. By involving physicians in the design of new models, including defining quality, cost and satisfaction measures upon which incentive payments would be based, ACHP member health plans continue to learn what is necessary for successful implementation.”
Website:
Press Release:
ACHP Joins Health Care Payment Learning and Action Network

Alliance of Wound Care Stakeholders
Commitment Statement:
The Alliance of Wound Care Stakeholders has committed to educate its physician and clinician members to help them make the transition to alternative payment and delivery system models. Through educational speakers at our meetings and conference calls, the Alliance will inform our members about MACRA implementation focusing on advanced APMs and alert them to additional opportunities for learning through the LAN in order to achieve the highest quality, patient centered health care.
The Alliance has set a goal of having speakers regarding these topics at its meetings in 2016-17 and informing members on a continuous basis on new information regarding the implementation of advanced APMs.
Website:

AltaMed Health Services
Commitment Statement:
AltaMed Health Services is committed to progressing along the prospective payment continuum, assuming more global risk for our populations. We have set a goal of increasing Category 4 payments from 32% to 42% over the next two years.
Website:

American Academy of Family Physicians
Commitment Statement:
The American Academy of Family Physicians (AAFP) supports the LAN goal to accelerate the health care system’s adoption of effective alternative payment models (APMs) to reach 30 percent of all payments by 2016 and 50 percent by 2018.
The following is AAFP’s 2016-2017 goal related to payment reform:
Position family medicine practices to be successful in a value-based payment environment with an emphasis on MACRA by:
• Leveraging the FPM journal as a consistent communication tool to raise awareness and educate members about advanced APMs;
• Developing a portfolio of products and services to facilitate adoption of Category 3 and 4 models;
• Connecting members with available technical assistance programs (MACRA TA, TCPI, CPC+, QIN-QIOs, RECs, etc
Website:

American Association of Hip and Knee Surgeons
Commitment Statement:
The American Association of Hip & Knee Surgeons supports the goals of the LAN and the development of risk-adjusted, data-driven Advanced APMs that ensure sustainability of access to care for our members’ patients.
- AAHKS aims to work with payors and members to ensure CJR and BPCI are included as Advanced APMs under MACRA to ensure sustainability of access to care for our members’ patients
- AAHKS created an Advanced APM Work Group to take on this issue and explore the best ways for our organization to support our members’ transition into APMs, through education and potential partnerships, before January 1 when MACRA is implemented
- The Work Group recently polled our members about their participation in Category 3 APMs and learned that half are enrolled in CJR and BPCI. A majority of the half that are not enrolled in a bundled payment program are interested in joining an APM
- AAHKS is educating our members about Advanced APMs; we have created a page on our site to educate about MACRA and APMs vs MIPS
- We will monitor the progress of education of our members through intermittent polls throughout the year to ensure education about APMs grows, leading to increased adoption
- Develop and revise quality measures that are linked to payment for hip and knee arthroplasty
AAHKS representatives are working with the American Academy of Orthopaedic Surgeons to develop APM education and models for our surgeons
Website:

American Association of Retired Persons
Commitment Statement:
AARP fully supports the Health Care Payment Learning and Action Network. We have long advocated for the use of alternative payment models and value-based purchasing. We look forward to working with others to better promote and educate these initiatives to our members, as well as all Medicare beneficiaries when possible.
Website:

American Cancer Society
Commitment Statement:
The American Cancer Society and its advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), are pleased to join the Health Care Payment Learning and Action Network to promote a more value-driven health care system for cancer patients, survivors and everyone at risk for the disease. By involving a broad group of stakeholders that are committed to working together, this effort could move us closer to achieving the triple aim of better care, better health and lower costs system-wide. The Society and ACS CAN are committed to working with our partners in this initiative in the coming years to encourage the development of care delivery models that incorporate a patient-centered approach to care and educate people with cancer and their families about models that improve the overall quality of care.
Website:

American College of Cardiology
Commitment Statement:
The ACC is committed to reporting progress toward national APM goals and is ready to set organization-specific goals for AMPs as follows:
- Actively engage in the Network by contributing to workgroups, sharing best practices, and learning from peers
- Work with Network participants to establish standard definitions for alternative payment models
- Monitor and report on trends and ACC member involvement in APMs
- Educate and engage member to increase awareness of and participation in alternative payment models.
Website:
American College of Cardiology
Press Release:

American College of Physicians
Commitment Statement:
The American College of Physicians (ACP), representing 141,000 internal medicine physicians (internists), subspecialists, and medical students, is committed to the implementation of alternative payment models, including the Patient-Centered Medical Home (PCMH), the PCMH neighborhood/specialty practice model, and accountable care organizations (ACOs). ACP has developed numerous tools and resources to help physicians make the transition to these alternative payment and delivery system models, and through its High Value Care initiative and its Center for Patient Partnership in Healthcare, has promoted ways for patients and clinicians to work together as partners to achieve the highest quality, patient-centered health care.
Website:
American College of Physicians
Press Release:

American Heart Association

American Physical Therapy Association (APTA)
Commitment Statement:
APTA supports the transition to value-based payment models and is committed to ensuring the success and viability of the physical therapy profession as the health care system evolves. We strongly believe that the success of APMs in improving the quality of care and decreasing costs will depend on the collective efforts of all health care providers throughout the health care spectrum, including physical therapists in private practice, home health agencies, rehabilitation agencies, inpatient rehabilitation facilities, skilled nursing facilities, and other providers.
APTA is exploring a variety of opportunities for partnership regarding the inclusion of physical therapy in APMs:
- Other provider groups with a similar interest in improving patient outcomes with the use of physical therapy.
- Existing APMs (including Advanced APMs), in which physical therapy can have an impact on outcomes, quality, and cost
- Health plans (Medicare, Medicare Advantage plans, and commercial) who are interested in innovative payment models in which physical therapy can make an impact
Actions:
- Test APMs with collaborative partners to determine the impact of physical therapy services on outcomes, quality, and cost
- Provide educational programming related to APMs and payment reform at conferences and external stakeholder events
- Promote physical therapist participation in APMs
Activities:
- Educate members/stakeholders/consumers on the importance of APM adoption
- Provide written and technical resources and assistance in support of APM adoption
- Spread best practices around APM adoption
- As applicable, serve as a “convener” to support and promote APM adoption
- Influence policy makers regarding the merits of APM adoption
- Invite LAN experts to speak at meetings/events
- Share LAN materials and information
- Encourage partners and stakeholders to provide input into LAN activities
- Provide leadership on and participation in LAN committees and work groups
Website:

AmeriHealth Caritas
Commitment Statement:
35% of our members being in a value based model by 2016 and 40% by 2017
Website:
Press Release:

Anthem Blue Cross Blue Shield
Commitment Statement:
Anthem is already far along in driving payment reform. Today over 38% of our members receive care from providers who are participating in one of our value-based payment programs. That percentage continues to grow annually. We are fully supportive of the goals set forth by HHS Secretary Burwell and of the Health Care Payment Learning and Action Network. As an organization, we will meet or exceed those goals.
Website:

Aria Health
Commitment Statement:
Aria Health strategically has adopted the belief that value-based care is not only unavoidable, but more importantly, it is the right thing to do for appropriate patient-centered, evidence-based care. This transition will require innovative APM’s with associated quality metrics to measure the progress toward population-based payments, while at the same time allowing financial viability during the transition.
Progress will be measured not only by the number of lives and/or various payer programs involved with APM’s, but also by the maintenance of quality outcomes and financial stability during this process.
Our timeline for transition mirrors the goals set forth by CMS and the Health Care Payment Learning and Action Network, with approximately thirty percent of health care payments being linked to quality and value by the end of 2016 and approaching or exceeding fifty percent by the end of 2018.
Website:

Arizona Health Care Cost Containment System
Commitment Statement:
AHCCCS is committed to leverage Arizona’s successful managed care model to continue to address the inadequacies of the current health care delivery system such as fragmentation, and to continue to lead efforts to bend the heath care cost curve to sustainable levels. By 2019, 50% of all payments made by all types of contracted managed care organizations to providers will be under a value-based structure (i.e., Category 2C, 2D, 3, or 4 of the APM Framework). AHCCCS will work to continue to shift an increasing percentage of payments into Categories 3 and 4.
Website:
Arizona Health Care Cost Containment System

Arkansas Blue Cross and Blue Shield
Commitment Statement:
Arkansas Blue Cross and Blue Shield is committed to working with key stakeholders to redistribute healthcare dollars in support of high quality, economic efficiency and a better patient experience. The way healthcare services have been paid for in the past has created a fragmented system that has caused friction between stakeholders who must work together to create new and improved value. Alignment of incentives for all participants to encourage innovation is the best way to move to better value, and we are committed to do all we can to support this movement.
Website:

Arkansas Department of Human Services
Commitment Statement:
Value-based purchasing models in Category 2 and 3 are incentivizing providers to deliver higher-quality and more cost efficient care – ultimately controlling the growth of costs in the state. Arkansas’s Model focuses on two complementary strategies: population- and episode-based care delivery and payment, with the intent to shift more payments into Category 3 and 4 over time.
Website:

Asian & Pacific Islander American Health Forum
Commitment Statement:
The Asian & Pacific Islander American Health Forum (APIAHF) supports the goals of the Health Care Payment Learning & Action Network. As an organization working to advance the health and well-being of over 18 million Asian Americans, Native Hawaiians and Pacific Islanders, we strive to ensure that a move toward a more value-based health system is truly patient-centered and meets the needs of all persons, including those who are limited English proficient, immigrant and/or face additional barriers to accessing health care.
Website:
Asian & Pacific Islander American Health Forum

Ascension
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020.
Website:

Atrius Health
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020
Website:
Press Release:

Avamere Health Services
Commitment Statement:
Actively participating in CMS BPCI model 3 pilot program and explore with commercial payers alternative models of payment.
Website:

Aver Inc.
Commitment Statement:
Aver’s mission is to simplify value-based healthcare. We provide technology solutions and strategic support to help healthcare payers and providers design, implement, and operationalize value-based healthcare and bundled payment programs. We commit to leveraging our tools and insights so that organizations can achieve a rapid and measurable increase in the percent of payments operating under value-based arrangements.
Actions:
- Provide payers the analytics needed to price bundled payments.
- Provide payers the strategy and support necessary to successfully go to market with priced episodes of care.
- Once the bundled payment contracts are signed, Aver’s analytics allow payment reconciliation and provider performance reporting.
Commitments:
- Educate members/stakeholders/consumers on the importance of APM adoption
- Provide written and technical resources and assistance in support of APM adoption
- Encourage business associates to operate under value-based payment arrangements/APMs
- Provide leadership on and participation in LAN committees and workgroups
Website:

Blue Cross and Blue Shield of Kansas City
Commitment Statement:
Blue KC has set an aggressive 5-year goal of continual advancement in the establishment of Category 3 and 4 alternative payment models (APMs) with the aim of at least 70% APMs by 2020.
Website:

Blue Cross and Blue Shield of Louisiana
Commitment Statement:
BCBSLA is committed to increasing the percentage of Category 3 and 4 provider payments tied to APMs from FFS and moving providers up a risk continuum. We have a goal of reaching 50% total medical spend paid to providers contracted under Category 2, 3, and 4 APMs by the end of 2016 and 60% by the end of 2019. Actions being taken to achieve these goals are enrolling additional providers in our existing APMs, implementing other incentive models tied to cost and gain sharing, and implementing new APMs to engage specialists. We also have a goal to increase our locally controlled membership penetration rate in value based programs to 24% in 2016.
Website:

Blue Cross Blue Shield of Massachusetts
Commitment Statement:
BCBS MA supports the LAN’s goals of having 30% of U.S. health care payments under APMs by Dec 2016 and 50% by 2018. BCBS MA commits to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For our Commercial and Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
Website:

Blue Shield of California
Commitment Statement:
Blue Shield of California supports the U.S. Department of Health and Human Services’ efforts to improve the cost and quality of health care in America, and is proud to participate in the Health Care Payment Learning and Action Network launched recently by President Obama and Secretary Burwell. As part of our participation, Blue Shield has committed to having 40 percent of our healthcare spending in value-based payment models by 2016, and 60 percent by 2018.
The Network’s goal to advance payment models that reward high-value and high-quality care is aligned with our mission and consistent with our strategy. Our efforts started more than 30 years ago, with risk-based compensation models, pay-for-performance programs and, more recently, bundled and global payment models.
In 2010, Blue Shield launched our first Accountable Care Organization (ACO), a collaboration with providers that has delivered impressive results by improving coordination of care and reducing costs. The program is a strategic priority for Blue Shield in order to help stem the rising cost of health care while improving quality and delivering a better patient experience. Our model is predicated on a robust framework of aligned financial incentives and shared governance with our hospital and physician partners, and a commitment to the principle that only the best clinical processes can yield meaningful benefits over time. The program has thus far delivered savings to our customers in excess of $313 million and resulted in an aggregate cost of health care increase of about 3 percent annually, roughly half the increase of our non-ACO business.
Since 2010, we have consistently expanded our ACO program. We now have 22 ACOs operating throughout the state, including the San Francisco Bay area, the San Joaquin Valley, Los Angeles, Orange County and San Diego, serving 263,000 Californians. In 2014, we launched our first Medicare Advantage ACOs and in 2015 we are offering a PPO ACO.
We commend President Obama, Secretary Burwell, and the other health plans and provider groups that have made commitments to join the Network and help transform the healthcare delivery system. Only by working together can we accomplish these critical goals.
Website:
Press Release:

Bluestone Physician Services
Commitment Statement:
Bluestone Physician Services serves complex Medicare and Medicaid patients exclusively through the model of on site integrated primary care and care coordination services for seniors and people with disabilities in assisted living, group homes, and community settings. Our specific goals are therefore aligned with the CMS goal of 30% of our population in alternative payment models by 2016 and 50% by 2018. We have a particular interest in models that incent practices to enroll high risk, complex patients.
Website:

Buying Value
Commitment Statement:
The success of the Affordable Care Act in expanding health care coverage and in reducing the uninsured by at least one-third is an historic achievement. But workers and their families who get coverage at work are still often stretched to the limit to pay for their share of that coverage. Without a massive shift from volume-based purchasing to value-based purchasing those people will never see relief from the crushing burden of excessive health care costs.
Buying Value is dedicated to this precise goal. We look forward to working with other stakeholders in the new network to optimize progress towards the Secretary’s goals.
Website:

Cambia Health Solutions
Commitment Statement:
As of 2016, Cambia’s regional health plans are engaged in over 50 value-based arrangements in APM Categories 3 and 4 with providers in our four-state region, including the states of Idaho, Oregon, Utah and Washington. Cambia Health Solutions supports the Health Care Payment Learning & Action Network’s payment reform goals and its work in accelerating the transition already underway in the industry toward alternative payment models. Our goal is to create value for consumers by engaging with providers in value-based arrangements and collaborative partnerships and to thoughtfully grow the number of agreements and number of members in Category 3 and 4 over time.
Website:

CAPG
Commitment Statement:
CAPG’s goal is for all CAPG members to have at least 90% of their Medicare (Original and Medicare Advantage) population in capitated payment arrangements by 2018.
CAPG VALUE GOALS
CAPG and its members are committed to advancing alternative payment models that include the following defining features:
(1) prospective, capitated payment to a multispecialty physician group;
(2) physician group provides care for a defined population of patients;
(3) medical group assumes responsibility for medical care, quality, clinical performance measurement, and accountability for administrative and financial performance.
CAPG’s goal is for all CAPG members to have at least 90% of their Medicare (Original and Medicare Advantage) population in capitated payment arrangements by 2018.
LEADERSHIP IN PROLIFERATING THE MODEL ACROSS THE COUNTRY
More than 50% of CAPG’s members are already participating in the above model to the fullest extent possible for their organizations. Other CAPG members have some experience with capitated payment in Medicare Advantage and are pursuing other types of alternative payment models, such as accountable care organizations, with their Original Medicare populations.
CAPG is committed to supporting its members’ achievement of this goal through its educational and advocacy programs.
CAPG’S COMMITMENT TO EDUCATION
CAPG will continue to educate medical groups about best practices via the Standards of Excellence™ Survey — a blueprint for the development of the clinical and financial attributes necessary to be successful in capitated models.
CAPG will continue to build programming into our annual conferences, regular committee meetings, and Capitol Hill briefings that prepares physician groups to accept clinical and financial risk in the future.
CAPG ADVOCACY
CAPG will work with likeminded organizations in Washington, D.C. to advance the policies necessary to build capitated payment opportunities in Original Medicare.
CAPG will advocate protecting and strengthening capitated delivery models where they are flourishing today, including in the Medicare Advantage program.
CAPG will advocate improving and expanding existing alternative payment models to set a foundation for organizations that want to take capitation in the future.
CAPG will continue to advocate for new models that allow physician organizations to test capitated payments in Original Medicare. As an example, CAPG has developed the Third Option, a new delivery model that uses a capitated payment model to foster high quality coordinated care for seniors.
Website:
Publications:
CAPG Guide to Alternative Payment Models

Care Coordination Systems
Commitment Statement:
A Pathways HUB Connect is an efficient regional infrastructure that improves health outcomes and reduces costs by connecting those at risk to quality community care coordination services. The HUB’s care coordination enables providers who might not otherwise enter a Category 3 or 4 APM to do so, and helps them thrive within that environment by effectively and collaboratively managing the care coordination services that determine their quality payment.
Care Coordination Systems commits to supporting the LAN’s goals by enabling providers to enter into and thrive in alternative payment model arrangements. Wherever our Pathways HUB Connects are currently located, Care Coordination Systems will actively seek out and engage providers to progress further along the APM Framework continuum. For communities without a Pathways HUB Connect, we will work with committed core groups of at least twenty (20) providers and willing payers to initiate a Pathways HUB Connect. Our specific goal is to engage with a minimum of five (5) providers dedicated to success in a Category 3 or 4 APM at each current Pathways HUB Connect by December 31, 2017. We intend to add ten (10) new Pathways HUB Connects (or start-ups) in the United States by December 31, 2017.
Website:

Care Oregon
Commitment Statement:
We are excited to share our full support the LAN’s goals of tying 30 percent of U.S. health care payments to APMs by 2016 and 50 percent by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For both our Medicaid and Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework. As an organization that prides itself on innovation, we want to be an active partner in moving U.S. health care forward.
Website:

The Carolinas Center for Medical Excellence
Commitment Statement:
As the QIO for South Carolina, The Carolinas Center for Medical Excellence is committed to helping practices move to APMs through our contract cycle, which ends July 2018, as we understand the importance and need for a successful transition. We will serve as a catalyst and convener for the HCPLAN by working with interested clinicians through promotional strategies that include, but are not limited to, email blasts, newsletters, and website promotions, as well as through our partners’ meetings, newsletters and websites. All recruited clinicians will be provided guidance, tools, and resources during the process. This collaborative effort will include quarterly interactive learning/webinar sessions and assistance with tracking their progress of transitioning to an APM.
Our goal is reach 6500 providers over the next 2 years. We will survey our providers and partners to assure we are proving timely, meaningful information to help them move through the stage of MACRA advancing to APM. We monitor the attendance at LAN events and satisfaction in an internal dash board. This information is shared at quarterly stakeholder meetings which include provider representation, Medical Society and other professional support organizations. Together, we partner to increase awareness and address local challenges.
We also receive annual CMS updates on all eligible providers’ performance which will indicate on a global level the state’s progress in adoption of APM.
Website:

Center for Health Innovation and Implementation Science
Commitment Statement:
The Center for Health Innovation and Implementation Science (CHIIS) and Indiana Clinical and Translational Sciences Institute’s mission is to develop tools, processes, and strategies for rapid, efficient, and sustainable implementation of evidence-based programs and practices into local environments to deliver high-quality, patient-centered and cost-efficient health care solutions aimed at producing better patient and family experience.
CHIIS is committed to ensuring over 15,000 clinicians are prepared to take on risk in alternative payment models by increasing their ability to
1) implement and localize evidence-based practices;
2) understand clinical informatics and data analytics to make data driven informed decisions;
3) utilize tools of behavioral economics to engage patients and clinicians in transformational change; and
4) master the personalization needed to manage the health of large populations.
Through CHIIS’ project, the Great Lakes Practice Transformation Network (GLPTN), funded by CMMI’s Transforming Clinical Practices Initiative, CHIIS is preparing clinicians for changes in healthcare reimbursement. GLPTN has already adopted several core principles from the APM framework and are working to build a person and family engagement strategy to empower patients to be partners in their healthcare. GLPTN supports population based payments by engaging providers in the use of population health management, chronic care management and care coordination, not just focusing on episodic improvement. We will be in strong support of clinicians with desires to join an alternative payment model that takes risk and quality into account.
Website:
Center for Health Innovation and Implementation Science
News:
Feds select IUSM to lead Midwest portion of national clinical-transformation program

Center to Advance Palliative Care (CAPC) at Mt. Sinai School of Medicine
Commitment Statement:
The Center to Advance Palliative Care (CAPC) provides training, tools and technical assistance to both payers and providers as they seek to improve the care of those with serious illness. Palliative care is one of the best opportunities to simultaneously improve quality, satisfaction and cost effectiveness, and CAPC’s mission is to ensure access to high-quality palliative care for all whom would benefit.
CAPC has two goals concerning alternative payment models:
a) to help risk-bearing entities incorporate palliative care into episode- and population-based models; and
b) to help palliative care providers secure alternative payments arrangements that support their work.
Specifically, CAPC aims to disseminate publications and presentations on best practices of palliative care in risk-based care delivery, along with training community-based palliative care programs in APM contracting.
Website:

Centra Health
Commitment Statement:
We are committed to rapid, measurable change, both for ourselves and for our country. We commit to having 75% of our respective businesses operating under value-based payment arrangements by 2020.
Website:

Children’s Mercy Integrated Care Solutions
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We currently have a proportion of payments in Category 3A and 4B arrangements. Our goal and intent is to shift more payments into Category 3 and 4 over time.
Website:

Cigna
Commitment Statement:
We will meet the goals set by CMS, including 90% of payments in value-based arrangements by 2018 and 50% of payments to organizations in alternative payment models by 2018. We will particularly focus on ensuring that our most vulnerable and at-risk customers are receiving care from physicians with who receive an incentive and assistance from Cigna to ensure quality, affordable care for those customers.
Website:

Clarify Health Solutions
Commitment Statement:
Clarify Health’s mission is to guide every patient through a delightful and affordable care journey. Clarify’s digital predictive analytics and patient guidance solution enables our provider and payer partners to reliably deliver personalized care journeys, leading to lower cost, higher quality, more satisfactory care –regardless of the specifics of the payment model. We commit to collaborating with our current and future partners in accelerating the transition to and successful implementation of Category 3 and 4 APMs. To demonstrate our commitment to the success of our partners and their patients in this transition, Clarify aligns our fees to our partners’ ability to achieve operational improvements and financial upside in value-based programs.
Activities
- Develop a truly distinctive solution for payers and providers in APMs to optimize workflows and patient care journeys
- Deliver the digital platform, including the predictive analytics and real-time patient guidance, that payers and providers need to confidently negotiate and succeed in APMs
- Align our incentives with those of our partners with ongoing support and outcomes-based fee structures to facilitate the transition to APMs
Commitments
- Educate members/stakeholders/consumers on the importance of APM adoption
- Provide written and technical resources and assistance in support of APM adoption
- Spread best practices around APM adoption
- Encourage business associates to operate under value-based payment arrangements/APMs
- As applicable serve as a “convener” to support and promote APM adoption
- Share LAN materials and information
- Encourage partners and stakeholders to provide input into LAN activities
- Provide leadership on and participation in LAN committees and workgroups
Website:

Coalition to Transform Advanced Care (CTAC)
Commitment Statement:
C-TAC, a non-partisan, not-for-profit coalition of 140 national and regional organizations working to transform the care of those with advanced illness, supports the use of new care delivery and alternate payment models that promote person-based and family-centered care for those with advanced illness.
Website:

Colorado, State of
Commitment Statement:
To provide access to integrated primary care and behavioral health services in coordinated community systems, with value-based payment structures, for 80 percent of the state’s residents by 2019.
Website:

Coastal Carolina Health Care
Commitment Statement:
To move to value-based payments as soon as we can convince payers to do so reasonably.
Website:

Community Catalyst Center for Consumer Engagement in Health Innovation
Commitment Statement:
Community Catalyst is a national non-profit advocacy organization dedicated to quality affordable health care for all. Since 1998, Community Catalyst has been working to build the consumer and community leadership required to transform the American health system. Community Catalyst established the Center for Consumer Engagement in Health Innovation as a hub devoted to teaching, learning and sharing knowledge to bring the consumer experience to the forefront of health.
The Center works directly with consumer advocates to increase the skills and power they have to establish an effective voice at all levels of the health care system. We collaborate with innovative health plans, hospitals and providers to incorporate the consumer experience into the design of their systems of care. We work with state and federal policymakers to spur change that makes the health system more responsive to consumers, particularly those who are most vulnerable.
We support the work of the Health Care Payment Learning and Action Network toward payment and care delivery models that can drive high quality, coordinated, and person-centered care and will continue to work with our consumer advocate partners in over 40 states to support this aim. We will share material about alternative payment models, including a statement of principles for patient- and family-centered payment, and will alert our partners to opportunities to provide input into LAN activities.
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Community Health Choice
Commitment Statement:
Community will continue to focus on ensuring that our Members receive care from providers who obtain an incentive from Community render quality, affordable care for those Members. We support the LAN’s goals of tying 25% of health care payments to APMs by the end of 2018 and 50% by 2020. We commit to continue to measure progress toward these goals on an on-going basis.
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Community Health Plan of Washington
Commitment Statement:
CHPW looks forward to actively supporting the achievement of the LAN’s goals of tying 30 percent of U.S. health care payments to APMs by 2016 and 50 percent by 2018. CHPW commits to continue to measure progress toward these goals on an on-going basis. Washington State is pursuing similar APM goals across its health care marketplace and CHPW is committed to partnering with the State and Federal Government to achieve APM goals and measure progress. As an organization that prides itself as being on the leading edge of health transformation, while maintaining a keen focus on serving safety net populations, CHPW looks forward to moving health reform forward to achieve better care, smarter spending and healthier people.
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Connecticut, State of, Office of the Lt. Governor
Commitment Statement:
Connecticut’s commercial and Medicare payers are currently implementing value-based payment models that fall into Category 3A. Connecticut Medicaid administers a PCMH program that falls into Category 2C.
CT SIM is promoting multi-payer alignment around value-based payment, and specifically, payment models similar to the Medicare shared savings program (SSP). Commercial and Medicare payers are focused on moving toward Category 3B. Medicaid is currently focused on moving a greater proportion of payments into Category 3A and considering other models.
A substantial portion of SIM funding is being used to support the development and implementation of the Medicaid PCMH+ program, which is a SSP model. CT aims to have 64% of the population participating in a SSP by 2018 and 88% by 2020. In addition, CT SIM is promoting greater alignment among public and private payers in their choice of quality measures for their SSP arrangements.
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State of Connecticut – Office of the Lt. Governor

Covered California
Commitment Statement:
As California’s health insurance exchange, Covered California enables individuals and small businesses to purchase health insurance while continually working to improve care for all Californians. Recognizing that improving value for our enrollees requires changes to the California health care delivery system, Covered California strongly supports the LAN’s work to accelerate the adoption of Alternative Payment Models (APMs). We encourage our plans’ efforts to implement Category 3 and 4 APMs to move towards the LAN’s goals. To support the shift toward APMs, Covered California will continue to collect quality information and encourage our plan partners to participate in LAN National APM data collection efforts and to modify their payments to increase value.
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Dallas-Fort Worth Hospital Council Foundation
Commitment Statement:
DFWHC Foundation will educate our affiliated health systems and physician providers about – and promote broad adoption of – alternative payments models, including the Patient-Centered Medical Home (PCMH), the PCMH neighborhood/specialty practice model, and accountable care organizations (ACOs). DFWHC Foundation will develop numerous tools and resources to help providers make the transition to Category 3 and 4 alternative payment and delivery system models and will continue its participation as a Department of Health and Human Services contractor for Medicaid providers in Texas as well as continue its support of physician office adoption through the Regional Extension Center. We will utilize and contribute to the LAN to share our findings and best practices as well as learn from the successes of others.
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DC Department of Health Care Finance
Commitment Statement:
DC is actively implementing value-based purchasing to reduce health disparities, enhance health care quality, improve outcomes, and promote wellness. Currently, the majority of our current and projected payment models are or will be organized in Category 2 of the APM Framework by 2018. DC is also developing alternative payment models and has set a goal that 50% of payments will be tied to a Category 3 or 4 APM by 2021.
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Delaware, State of
Commitment Statement:
80% of the State’s population receiving care through value-based payment and service delivery models within 5 years.
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Delmarva Foundation
Commitment Statement:
Delmarva Foundation supports the Health Care Payment Learning & Action Network by working through our QIN-QIO Scope of Work in the District of Columbia; Quality Improvement through Quality Reporting Programs and Support of Clinicians in the Quality Payment Program. We will provide technical assistance to primary care and specialty practices to move toward a healthcare delivery system based on value, not volume. We will track how many practices we educate about the MACRA Quality Payment Program and how many join Category 3 and 4 alternative payment models over the next three years based on assistance we provide.
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Dignity Health
Commitment Statement:
Dignity Health will have 50% of payment in accountable care by 2018, 75% by 2020.
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Duke-Margolis Center for Health Policy
Commitment Statement:
The Duke-Margolis Center for Health Policy draws on expertise from across Duke University to create the research and data infrastructure necessary for empirical analysis of challenging healthcare delivery and payment reform questions. Working with the Duke Clinical Research Institute and other collaborators, Duke-Margolis is creating an Evidence Hub that will bring together expertise, best practices, and multiple data sources under shared governance structures for data curation and use. With input from the LAN Guiding Committee, this resource will empower faculty and research teams to address key policy questions related to health care delivery, with particular attention to payment reform in support of Category 3 and 4 payment models. The Evidence Hub and the LAN are partners in this work.
The Center will also collaborate with multiple entities within Duke Health to create structures necessary for piloting new ideas to deliver, finance, and regulate health care. The work will be at multiple levels, from supporting Duke Health’s strategic direction and leadership in care delivery, to state and regional improvements, to national policies, to international collaborations.
The Center will measure progress based on the level of evidence it has helped to generate, as well as the number of partnerships it has developed around payment reform implementation.
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ECL Group
Commitment Statement:
Within the ECL Group’s umbrella are all the tools necessary for an ophthalmologist to move towards category 3 and 4 APMs. We have hosted user group meetings, developed magazine articles and employed free practice consultants to work with practices.
We will continue to educate our clients on APMs, the use of technology and how they can participate through our user groups and individual client implementation. We will offer solutions on financing, claims data, reporting and practice building for patient engagement. We currently offer these solutions and will continue to use the APM Framework to assist moving the Eye Care Community toward these payment models. Currently more than 6,000 physicians are represented by our technology and services.
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Elevation Health Partners
Commitment Statement:
Elevation Health Partners is a team of quality improvement, public health, and technical health care consultants. We collaborate with state and federal agencies and commercial health care organizations to develop and implement strategies to advance meaningful, measurable improvements in all areas of the health care delivery system. We specialize in Medi-Cal and Medicare, evidence-based chronic disease management, primary care and specialty care integration, and work to drive sustainable large-scale transformation to advance new payment models and build provider capacity for quality.
As part of CMS’s Transforming Clinical Practice Initiative (TCPI), Elevation Health Partners works with 22 Federally Qualified Health Centers across Los Angeles County. The overarching goal of TCPI is to achieve large-scale health transformation by developing quality improvement strategies that readies practices to participate in an alternative payment model. The TCPI, one part of a strategy to strengthen the quality of patient care and spend health care dollars more wisely. supports innovation by promoting broad payment and practice reform in primary care and specialty care.
Using data to drive care, Elevation Health Partners has some notable achievements with our 22 assigned FQHCs:
- Evaluate and select an organization-wide risk stratification methodology. None of the health centers were stratifying risk for the clinic population. Now, all 22 health centers stratify risk for the diabetic population and those needing mental health services to ensure case management aimed to prevent hospital admissions and readmissions.
- Empanel Providers. Empanelment is demonstrated to reduce overall system costs, through healthier patients, fewer emergency room visits and hospital readmissions. Recognizing lack of technical tools for empanelment, Elevation Health Partners developed an Access Database tool. Only 5 of 22 health centers were empaneling providers prior to Elevation Health Partners assistance. Now all 22 health centers are actively running empanelment calculations, adopting best practice policies and procedures for empanelment, obtaining board approval, and are expected to upload empanelment assignments in the EHR by June 2018. The next phase of this effort includes implementation support, quality control, and data monitoring.
- Improve data validation and reduce data leakage. Throughout 2017, Elevation Health coaches provided in-depth education and hands on support on proper EHR documentation, encounter, coding and claims submissions. This resulted in a 25% improvement for HbA1c poor control levels and 28% improvement in depression screening and follow-up across all practices year-to-date. This not only provides a greater amount of incentive dollars to our practices, but additionally resulted in a reduction in health care dollar expenditures.
Activities:
The following are ways in which we prepare clinicians to take on risk in alternative payment models:
- Develop and provide strategic guidance to county government, health plans, IPAs, associations, advocacy groups, and clinic leaders in the LAPTN Transforming Clinical Practice Initiative (TCPI)
- Provide hands on and technical support in practice assessment, quality improvement, and evidence-based care guidelines to drive and accelerate health care delivery system transformation
- Offer PCMH content support and technical assistance to achieve and advance NCQA PCMH recognition
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Evolent Health
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020.
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Excellus Blue Cross Blue Shield
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
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FamiliesUSA
Commitment Statement:
Families USA will inform its extensive, nationwide network of state-based consumer advocacy organizations about CMS’ alternative payment models for Medicare designed to improve quality and lower cost. Families USA will solicit their input and share it with the Health Care Payment Learning and Action Network and its working groups to provide for a robust consumer voice.”
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Geriatric Specialty Care
Commitment Statement:
Geriatric Specialty Care is currently in Category 2D of the APM Framework and we are preparing for a transition to 3A. Our current efforts include a CCM program that has seen steady growth month over month with increased quality outcomes.
Geriatric Specialty Care has recently signed an agreement to join an ACO in Northern Nevada as their Transitional Care/Frail Elderly provider group. We believe the ACO payment model is structured to provide the right incentives to support our care delivery model. We are committed to participating and sharing our lessons with others to help achieve the LAN’s payment reform goals.
Geriatric Specialty Care will support our ACO and its payment model in five areas:
1. Transitional Care Management – See 100% of patients on discharge, reconcile their medications when they transition, keep return to acutes below 8%.
2. Chronic Care Management – Meet requirements on 300 patients per month (28% of population) and to update and review 68% of all care plans monthly.
3. Advanced Care Planning – Have 100% of our patients receive Advanced Care Planning on a yearly basis.
4. Illness Burden – Better capture Illness Burden via HCC’s.
5. Scope of Work – Educate and allow all clinicians (CMA, CNA, RN, LPN, LCSW, APRN, PA-C, MD, DO) to perform at the top of their scope/ability. It is a community collaboration effort.
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Articles:
Using Primary Care Payment Models as a Catalyst for Improvement – Journal of the American Medical Doctors Association, May 2017

Gold Coast Health Plan
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
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Great Plains Quality Innovation Network
Commitment Statement:
As a Quality Improvement Organization, we understand the importance of and fully support measuring progress towards goals, both in the HCP LAN and internally within our organization. We commit to leveraging our quality improvement work to support the providers across the healthcare spectrum being introduced to these alternate payment models for the first time. We have been supporting healthcare providers throughout the various payment model/incentive changes for many years, including Hospital Value Based Purchasing, PQRS, Meaningful Use, the Readmission Reduction Program, and the HAC Reduction Program.
Great Plains QIN commits to continuing to be the local “go to” organization for providers with questions about CMS quality and payment initiatives. Some of the work that we are currently performing in the 11th Statement of Work – forming community coalitions to better coordinate care – confirms that we are a neutral convener of healthcare partners regardless of care setting, health system, or payer.
We have specific recruitment, technical support, and outcome goals in the 11th SOW that aligns very well with those of the LAN. A few examples of goals of moving to value over volume are:
- Recruiting 75% of our 1-star nursing homes to participate in a collaborative to improve quality
- Assisting 50% of our nursing homes to achieve a Quality Composite Score (a cumulative measure CMS created comprised of 13 quality measures) less than 6.0
- Lowering statewide readmissions and admissions per 1,000 beneficiaries by 2%
- Helping 55% of eligible hospitals perform better than the national median for the Hospital Value-Based Purchasing Program
- Helping 60% of MIPS-eligible clinicians complete CME/CEU education
The alternative payment models being introduced by CMS have already had a direct positive impact on our work. With the numerous quality improvement projects that providers have participated in over the last decade, they are seeing why it was important that we were working with them to reduce infections or avoid re-hospitalizations. Healthcare providers have realized that quality and payment will go hand-in-hand in the future.
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Greenville Health System
Commitment Statement:
Transition 30% of the System’s managed care contracts (physician and facility) to arrangements with value-based payments.
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Health Care Service Corporation
Commitment Statement:
75% of HCSC members into value-based payment systems by 2020 (HCTTF goal).
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Health Care Service Corporation
Press Release:
Providers, payers need to mend relationships to make value-based care system successful

Healthcentric Advisors
Commitment Statement:
Healthcentric Advisors and the New England QIN-QIO support the Health Care Payment Learning & Action Network’s goals by:
- Successfully achieving the tasks set forth in the QIN-QIO 11th Scope of Work to:
- assist clinicians in transitioning from fee-for-service payment models to APMs;
- improve the coordination of care; and
- to improve the quality and safety of care transitions through reduced hospital utilization and adverse drug events.
- Providing education and technical assistance in order for eligible clinicians to transition into APM Framework Categories 3 and 4.
- Serving as the TCPI neutral convener for the PTNs within our QIN-QIO region in order to share best practices, tools and resources to optimize the number of practices completing the transformation phases.
The goal for Healthcentric Advisors and the New England QIN-QIO is to reach 30,000 clinicians over the next 3 years and we will periodically measure our progress in achieving this goal.
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HealthInsight
Commitment Statement:
HealthInsight is developing a set of “True North” measures this summer for each of the communities that we serve. These measures represent our ongoing assessment of overall health and health care system performance. We intend to include the HHS metric of Medicare providers using alternative payment systems as a measure of the level of provider engagement in our communities on this dashboard.
We will also set goals for our region that parallel the HHS commitment and will work together with other community partners in each state to build infrastructure, programs, and technical assistance support to help providers achieve these same goals.
We will leverage our significant presence and interaction with providers in our region to directly link the 11th SOW goals with the HCPLAN objectives. Relevant areas for linkage will be turning data into actionable information, culture change aligned with alternative payment models, improved coordination of care across settings, and optimized patient engagement. In addition, as a trusted, neutral community convener, HealthInsight will bring together stakeholders in each state in our region periodically to discuss progress and barriers impacting the realization of HCPLAN goals.
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HealthPartners
Commitment Statement:
HealthPartners is excited to be recognized as a Committed Partner of the Health Care Payment Learning and Action Network (LAN). HealthPartners has developed and implemented Alternative Payment Models (APMs) with our provider partners for over ten years. Our Triple Aim approach has been implemented with many of our provider partners and it supports the LAN mission.
HealthPartners’ goal is to have over 85% of our members covered under APM contracts in Categories 3 and 4 by 2020.
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Health Services Advisory Group (HSAG)
Commitment Statement:
HSAG supports the Health Care Payment Learning & Action Network by working through our QIN-QIO SOW and our relationships with the Practice Transformation Networks (PTNs) to assist practices in transforming from a traditional, fee-for-service healthcare delivery system to one that is based on the value of care provided. This includes advanced alternative payment models, accountable care organizations or bundled payment arrangements which fall into the APM Framework Categories 3 and 4. HSAG also commits to providing technical assistance to practices regarding the implementation of MACRA and MIPS and successfully reporting relevant measures, improving the coordination of care through electronic exchange of health information, and implementing quality improvement activities to reduce unnecessary testing and hospital readmissions. HSAG will track the number of practices we work with to see how many advanced alternative payment models they join over time, and the percentage of their practice that remains under MIPS.
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Henry Ford Health System
Commitment Statement:
Henry Ford Health System is an integrated health care system that has included hospital and medical group components in a tightly aligned structure for over 100 years, and health plan, long-term care, and other components for 30 or more years. Henry Ford Health System is firmly committed to expanded participation in a variety of forms of Alternative Payment Models. There is a strong historic base already for participation in “alternative payment models”, with the Henry Ford Medical Group having provided care for Health Alliance Plan members (the System-affiliated health plan) under a full-risk capitation agreement for over 25 years.
We have recently begun participation in the CMS Next Generation ACO program (Category 3B in the HCP LAN APM Framework), and have applied for participation in the CMMI Oncology Care Model demonstration (Category 3A in the Framework) in both the provider and plan roles. We participate in a variety of value-based contracts with Blue Cross Blue Shield of Michigan, and have begun to develop agreements for tertiary and quaternary service provision with other local and regional ACOs. Most of these arrangements would be classified as Category 2C, since they involve tangible financial rewards for actual performance on defined quality metrics. We have recently joined the Federation Care Network, a collaboration of integrated health systems in Michigan that has been created to enter into value-based contracts with public and private payers.
The full-risk capitation arrangement that existed for many years between the Henry Ford Medical Group and Health Alliance Plan would exemplify a Category 4B model. The agreement has been modified recently to move to a form of shared risk between plan and medical group, but the financial risk still retained by the medical group (approximately one-third of total) represents a significant risk for a defined population held by a provider entity, and would also exemplify a Category 4B agreement.
The recently-completed “Strategic Path” for HFHS includes a strong commitment to growth of involvement in APMs, under three specific strategic programs:
(1) “Integrated Care and Coverage”, involving individuals who are both members of the HFHS-affiliated health plan (Health Alliance Plan) and patients in the HFHS delivery system at the same time;
(2) “Value-Based Care”, involving individuals who are patients in the HFHS delivery system but insured through a different private or public entity; and
(3) “Complex Tertiary Care” involving patients who come to HFHS for high-end specialty, inpatient, or procedural services, perhaps through bundled payment arrangements with a variety of payers.
We have declared a goal of expanding the pool of individuals in the “Integrated Care and Coverage” category from approximately 125,000 to 500,000 over the next 5-10 years. An expansion of this size would mean that “ICC” would expand from approximately 20% of overall system revenue to 50%. Progress toward that goal will be measured every year. We also expect that revenue in other domains (e.g., tertiary care) will also come increasingly through value-based contracts, but we do not have specific quantitative goals or timelines in those areas.
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HRHCare
Commitment Statement:
HRHCare is committed to engaging in alternative payment models that improve quality, reduce costs, and enhance patient experience of care. Specifically, we are seeking to reduce total cost of care for the patients we serve by 10% over the next five years and to have 75% of our payer relationships at an APM Category 2 by 2020 and to have 25% of our book of business moved to APM Category 3/4 by 2020. In addition to this general goal, through participation as a Committed Partner, HRHCare seeks to ensure that new models of care and supportive APMs are considerate of alternative healthcare providers, such as FQHCs. We believe that in order to achieve the goals set forth by the LAN, it will be critical to ensure that providers like FQHCs and rural health clinics that serve especially vulnerable and medically underserved communities benefit from the most innovative clinical models and accountability frameworks.
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Humana
Commitment Statement:
Improving Access to Accountable Care: While HHS aims to have 30% of Medicare payments in alternative payment models by the end of 2016 and 50% by the end of 2018, Humana has 53% of our members in accountable care relationships today and is on course to have more than 75% in accountable care relationships by 2017.
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Idaho Department of Health and Welfare – Office of Healthcare Policy Initiatives
Commitment Statement:
As part of Idaho’s pursuit of the Triple Aim, we will move from a FFS payment model (current environment – Category 1) that rewards volume of service to new value based payment models to incentivize better models of care and lower overall medical costs. This statewide payment transformation will involve a variety of approaches on the part of Idaho’s major payers, including commercial payers, Medicare and Medicaid. Idaho recognizes the importance of offering flexibility to payers in defining how they will support payment reform. Each payer is at a different place on the APM framework. For example, one payer is incentivizing providers through an accountable care organization model with shared, upside risk, expecting to evolve to a full risk model in the future.
Within this broader statewide payment model transformation, several of Idaho’s payers have committed to alternative payment arrangements with Idaho’s healthcare providers. These new payment models will incentivize, support, and reward the improved care given through the PCMH model, which will reduce high-cost care through patient management, including lowering ED utilization, hospital admissions and re-admissions, reduce neo-natal intensive care use, and increase the use of generic prescription medication. It is anticipated that these trends will decrease the cost of healthcare in the State.
Idaho has adopted the LAN framework of Alternative Payment Models and remains committed to transitioning Idaho from a fee for service structure to a population based payment structure. Commercial payers have demonstrated their commitment to negotiations that will lead to value-based payment arrangements with providers within their network that advance the goals. The payment transformation, both at a statewide level and in support of the SIM PCMHs, will not occur immediately. Transforming payment requires negotiations and contracting between the payers and providers. To avoid anti-trust, each payer must negotiate separately with each provider.
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Inland Empire Health Plan
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
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InnovaCare
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
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Media:

Integrated Healthcare Association
Commitment Statement:
The Integrated Healthcare Association (IHA) is a nonprofit multi-stakeholder leadership group that promotes healthcare quality improvement, accountability and affordability for the benefit of all Californians. Beginning in 2012, the program began a strategic transition toward value, incorporating resource use and cost into the public reporting and recommended health plan incentive design. The VBP4P incentive design, developed through a multi-stakeholder collaborative process, reflects an upside gainsharing methodology based on resource use that incorporates quality performance. The design also includes a standard value-based incentive, which combines quality and cost performance, for organizations that receive comprehensive population-based payments.
IHA’s goal is to have 100% of participating physician organizations receive value-based incentives through either of these Category 3A or Category 4B APM designs—consistent with the VBP4P recommendations and common measure set—from all contracted, participating health plans by 2018.
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Iowa Medicaid Enterprise
Commitment Statement:
Value Based Purchasing efforts in Iowa began in the private sector and Medicare in 2012 and in Medicaid in 2014. Currently Medicaid is working with newly implemented MCOs to develop VBP models that qualify by 2018 for payment Category 3 APMs. Through the SIM initiative and beyond, Iowa is committed to move more healthcare spending into Categories 3 and 4.
Iowa will use the SIM grant to implement and evaluate a sustainable health care delivery and payment system that will improve population health, improve patient care, and bend health care cost trends. The SIM Test aligns Iowa payers in payment reform that focuses on value; equips Iowa providers with tools to perform in value based, population focused models; and aligns and integrates public health strategies into how health care is delivered. Together, these approaches ensure a robust, statewide transformation to achieve Iowa’s SIM vision, “Transforming Health Care to Improve the Health of Iowans.” Iowa aims to:
– Reduce the rates of preventable events (i.e. Emergency Department (ED) visits and inpatient admissions) for individuals in a value-based purchasing arrangement by 20% by the end of the SIM test grant
– Increase the number of providers participating in Value-Based Purchasing (VBP) 50% and establish a decreased trend in Total Cost of Care (TCOC) by the end of the SIM test grant
– Improve the health of its population by the end of the SIM test grant in three of the SIM focus areas:
– Tobacco Use: Increase quit attempt rate by 5.1%
– Obesity: Decrease prevalence rate by 2.9%
– Diabetes: Increase A1C test rate for diabetics by 4.1%
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IPRO & The Atlantic QIN/QIO
Commitment Statement:
IPRO and its Atlantic Quality Innovation Network (AQIN), commit to developing innovative approaches to evaluate healthcare cost and quality that permit payers and consumers to readily identify performance that is high-value, based on the three-part aim of better health, better healthcare and smarter spending.
IPRO believes that the work we’re doing—highlighting physician practices that meet stringent Advanced Primary Care criteria and promoting the cost and quality performance of ACO-served geographic areas, versus non-ACO areas—offers important educational support to value-based payment reform. By advancing the learning curve among consumers, patients and family care-givers, we will be building the case for Category 3 and 4 APMs as a value proposition. While IPRO doesn’t provide care, we have an important role to play in educating the lay public on the importance of recognizing and rewarding high-quality, cost effective healthcare.
Advanced Primary Care Scorecard
IPRO’s Managed Care Department is currently designing an Advanced Primary Care (APC), scorecard to evaluate cost and quality performance at the individual practice level and across payers. The initial scorecard will include a total of 13 cost and quality measures, including hospital utilization, preventive care and total cost per member per month. Under the auspices of the New York State Department of Health, IPRO will offer technical assistance to health plans to assure data accuracy and to evaluate attribution logic. Additionally, IPRO will aggregate performance across payers, producing reports at the regional and state-wide levels.
Success of the APC scorecard will be measured by whether the NYSDOH converts this effort from a pilot-study to a required, publicly-reported performance report for practices across New York.
Why Not the Best Website
Additionally, IPRO will use the freely-available WhyNotTheBest quality improvement website it created and manages to compare and contrast the performance of Accountable Care Organization (ACO)-participating providers against non-participating providers. By accessing ACO “quality footprint” information, visitors to the website will be able to contrast quality and cost performance across dozens of measures between regions that are and are not served by ACOs. IPRO will collect and publish comparative cost and value information on a range of quality and utilization measures, including procedures, visits and imaging.
Success of the ACO “quality footprint” data collection and analyses will be measured by surveys of users, who will be asked to rank the website for timeliness, ease-of-use and other user experience measures.
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The Atlantic Quality Innovation Network-Quality Improvement Organization (AQIN-QIO)
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iTether, LLC
Commitment Statement:
For behavioral health treatment providers, iTether is the patient engagement platform that provides real-time patient activation for improved outcomes. Through the provider portal and patient app, iTether platform connects patients, providers, and payers to empower data-driven decisions across the continuum of care. We enable the delivery and measurement of treatment to more patients at a lower cost to improve long-term health outcomes.
iTether LLC’s mission is to raise the standards in behavior modification services by engaging patients, delivering accountability, and improving long-term success rates. Our products are customizable and integrated across all levels of treatment services – patients, providers, and payers. We deliver evidence-based outcomes which lead to performance-based payments. At iTether, we believe that documenting the delivery of treatment and resulting outcomes provides a strong foundation for a successful APM-based program.
We accelerate APM adoption by using modern data collection methods for surveys and assessments that extend beyond the clinical walls and support APM adoption by streamlining the correlation of patient-generated health data (PGHD) to contracted quality measures.
Clinicians use the iTether Patient Engagement Platform to provide ongoing guidance, quality surveys, and health assessments to patients outside of the clinical environment as part of patient care and case management. This includes the collection and use of patient-generated health data (PGHD), which is correlated to the Provider’s contracted Quality Measure Performance (QMP) incentive arrangement, under which the Provider may receive additional funds over and above the capitation rates for performance on select quality measures.
Activities:
- Create and capture value-based care data
- Support APM/ value-based care symposiums
- Support integrated healthcare teams in APMs to deliver patient-centered care
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Johnson & Johnson
Commitment Statement:
J&J has consistently supported payment and delivery reform efforts to promote quality of care and improve value while maintaining a strong incentive for innovation. Below are our commitments toward supporting value-based care:
- We will increase the percentage of J&J employee insured members receiving care through value based, coordinated care models (ACOs, medical homes, etc.) from 10% in 2015 to 30% in 2018 and 50% by 2020.
- We will engage employees in their health via personal digital health tools, connecting 100,000 employees worldwide by 2020.
- We will provide solutions that help encourage and improve the coordination of patient care.
- We will assess our new products for their impacts on quality measures that are relevant to new payment models.
- We commit to partner with providers and patient advocates on the clinical pathway and measure development process as we collectively work to achieve the Triple Aim.
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Media:

Kaiser Permanente
Commitment Statement:
Kaiser if virtually 100% population-based payment. Their goal is to 1) Provide expertise and contribute to work of the Health Care Payment Learning and Action Network. 2) Take an active role in helping create a process that mobilizes the health care industry to share best practices around value-based payments among participants.
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Press Release:

Kern Health Systems
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
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The Kinetix Group
Commitment Statement:
The Kinetix Group is committed to supporting health systems to improve their quality and cost of care. With this goal in mind, we help organizations gain analytical insights about their cost of care and quality metrics, streamline their processes and workflows, and identify solutions for obstacles they may encounter along the way.
Throughout all of our consulting services, we will provide direction for organizations to achieve the Triple Aim and adopt Category 3 and 4 APMs by:
1) Educating health systems and providers about APMs and prospective pathways to success
2) Gaining key insights from healthcare industry stakeholders about opportunities and barriers surrounding various APMs
3) Continuously promoting care coordination and patient engagement
4) Working closely with partner organizations to assist health systems and provider groups in proactively managing populations and reducing unnecessary utilization of services
5) Encouraging our clients to innovate and to utilize metrics to effectively implement initiatives that promote the Triple Aim
As a collaborator in the QualityImpact Practice Transformation Network participating in the CMS Transforming Clinical Practice Initiative, we will guide upwards of 4,000 providers on the path to transition from fee-for-service to value based payment models. With regular, 6 month reassessments, we can gauge their improvement and determine which areas they need to improve. Our goal is that, by the end of our 4 year program, the practices will see a $600 average per patient savings with a 30-35% improvement on key clinical outcomes such as diabetes, asthma, and heart failure. We will work closely with these facilities to see which APMs they adopt and their performance.
Website:

M3 Information
Commitment Statement:
M3 is a behavioral health research collaborative striving for better integration of behavioral health care and primary care. We strongly support adoption of alternative payment models, most of which rely on whole person view and use of measurement based care.
This can be accomplished through the use of an evidence-based assessment of mental disorders commonly seen in primary care (such as anxiety, bipolar disorder, PTSD, substance use disorder in addition to depression). These assessments support…
• Population-based care through tracking all individuals receiving mental health care
• Measurement-based care through the systematic use of mental health outcome measures supporting treatment and treatment adjustments
• Accountable care through the tracking of population attainment of mental health treatment targets and enabling ongoing quality improvement
It is M3 Information’s goal that by 2018, 50% of our business will be operating under public and private alternative payment models that include multi-dimensional behavioral health assessments. This will be done through our partnership with Laboratory Corporation of America (LabCorp), the world’s largest health care diagnostics company and its 800 person sales force. Measurement of this goal will be accomplished through identification the number of completed individual patient assessments from providers contracted under alternative payment models.
Integration of physical and mental health within payment bundles and alternative payment models results in better care, better health and lower costs.
Website:

Maine, State of
Commitment Statement:
Under Maine’s State Innovation Model, our goals are to have 61% of the Maine population covered under alternative payment arrangements by the end of Year 3 of Maine’s SIM cooperative agreement, which is 9/30/16.
Website:

Massachusetts, State of
Commitment Statement:
Notwithstanding any general or special law to the contrary, beginning on or before July 1, 2014, the group Plan commission, MassHealth and any other state funded Plan program shall, to the maximum extent feasible, implement alternative payment methodologies, as defined in section 1 of chapter 12C of the General Laws. Private health plans shall to the maximum extent feasible reduce the use of fee-for-service payment mechanisms in order to promote high quality, efficient care delivery. (This language is built into statute).
Website:

McKesson Corporation Connected Care and Analytics/Extended Care Solutions
Commitment Statement:
As a software vendor serving federally funded home health and hospice providers, our goal and commitment is to provide solutions to serve our home health and hospice customers.
Our products will continue to evolve to better serve our customers with implementation and support for alternative payment models in Category 3. From our perspective, the full impact of the various payment models has not been fully recognized in the post-acute care space. We will continue to work closely with our customer base and industry experts, such as LAN, as part of our commitment.
As Category 4 APMs provide details for home health and hospice, we will work with our customer base to support their needs.
We have started a process to measure APM activity in our customer base. We will obtain the findings and report by percentages.
McKesson is committed to serving our customers and being a champion for alternative payment models that improve patient outcomes.
Website:

Medicare Rights Center
Commitment Statement:
The Medicare Rights Center supports the goal of linking 50% of U.S. health care payments to quality and value through alternative payment models by 2018. Medicare Rights directly answers 20,000 Medicare questions each year on its free, multilingual helpline and will provide counseling to ensure that its clients — beneficiaries, caregivers, and professionals — are educated about Medicare-related alternative payment models.
Medicare Rights’ educational website, Medicare Interactive (www.medicareinteractive.org), receives nearly two million visits each year, and Medicare Rights will add content that describes alternative payment models in legally vetted, consumer-friendly language.
Finally, Medicare Rights will develop a set of consumer-oriented policy principles for informing the development and implementation of alternative payment models, building on the efforts of the Consumer & Patient Affinity Group (CPAG) of the LAN. In 2017, Medicare Rights will include these principles in a formal report to the Centers for Medicare & Medicaid Services (CMS) and others on the changing Medicare landscape and how consumers and consumer advocates can become more empowered within it.
Website:
Media:
Medicare Rights in Partnership with Health Care Learning & Action Network
LAN Fall Summit 2016 Key Themes: Partnership, Equity and Transparency

Michigan Department of Health and Human Services
Commitment Statement:
Michigan currently has a varied and competitive payment model landscape spanning all categories of the LAN framework. Recent partnerships with CMS have supported the state’s shift towards more unified approaches to payment reform.
- The Michigan Primary Care Transformation (MiPCT) demonstration project enhanced alignment in Category 2 payments across significant commercial payers, Medicare, and the State’s Medicaid administration during 2011—2016. The multi-payer platform developed in MiPCT will be leveraged moving forward to continue multi-payer payment reform in Michigan.
- There are a number of Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) and Next Generation ACOs in Michigan participating in Category 3 arrangements.
The State Innovation Model (SIM) partnership with CMS has ushered in the next phase of multi-payer payment reform. Both the MiPCT project and the SIM design process informed payment and care delivery reform changes to the recently procured Medicaid managed care contract, creating additional alignment across disparate payers in the State. The SIM implementation process has, in conjunction with the Medicare Access and CHIP Reauthorization Act (MACRA) incentives for advanced payment model (APM) participation, set the stage for data collection, goal setting, and performance improvement activities across payers.
In the future, Michigan will be collaboratively developing and implementing a strategy, timeline, and systematic methodology for measuring, benchmarking, monitoring, and incentivizing all payers to increase the percentage of medical expenditures paid through Categories 3B and 4.
Website:

Minnesota State Employee Group Insurance Program
Commitment Statement:
Minnesota’s State Employee Group Insurance Program (SEGIP) purchases health care for over 127,000 State of Minnesota employees, dependents, and retirees and is the largest employer purchaser of health care in the state. Minnesota Management and Budget also purchases health care on behalf of an additional 20,000 employees of local units of government through its Public Employee Insurance Program (PEIP). As a purchaser, MMB is committed to promoting increased use of value-based payment methods in health care through its contracts with health plan administrators and through risk-sharing arrangements with providers that incentivize performance on cost and quality.
Website:

Montefiore
Commitment Statement:
Montefiore Health System has set a goal by 2018 of 100% value-based payments from Medicare and Medicaid.
Website:
Press Release:
Montefiore Hosts HHS Secretary Burwell and Leading New York State Health Officials

Mountain-Pacific Quality Health
Commitment Statement:
Aligning Medicaid payment reform
To ensure payment reform and quality, our staff is working with the Montana Medicaid State Innovation Model grant staff, executive leadership and consultants to assure that Medicaid payment reform aligns with MACRA. Through this alignment, we build visibility—bringing payers, key stakeholders and consumer groups to the table. This collaboration creates synergy around the following top priorities:
- Committing resources to develop a viable health information exchange that includes all payers.
- Promoting integrated behavioral health models, including the Billings Clinic Project ECHO model, launched in January as the first Montana-based hub. Project ECHO, Billings Clinic is utilizing this model to establish a collaborative and peer support for addiction and behavioral health clinicians working within the Department of Corrections to care for offenders who are incarcerated or transitioning back into the community.
- Reducing readmissions in rural settings using a model based on the Camden Coalition of Healthcare Providers. This model focuses on patients known as “super-utilizers” of the health care system. One percent of these patients can account for more than 20 percent of total health care expenditures. They usually have multiple chronic conditions, emergency department visits, hospital admissions, mental health concerns, substance abuse concerns and/or complex social barriers to receiving care.
- Continuing to educate patients and families so they have the information they need to make informed choices. Patient and family engagement should be the cornerstone of health care quality and reform with the end results being better care, smarter spending and healthier people.
Website:

Montana Department of Public Health and Human Services
Commitment Statement:
Aligning Medicaid payment reform
To ensure payment reform and quality, Montana Medicaid State Innovation Model grant staff is working with our QIN-QIO Mountain-Pacific Quality Health, executive leadership and consultants to assure that Medicaid payment reform aligns with MACRA. Through this alignment, we build visibility—bringing payers, key stakeholders and consumer groups to the table. This collaboration creates synergy around the following top priorities:
• Committing resources to develop a viable health information exchange that includes all payers.
• Promoting integrated behavioral health models, including the Billings Clinic Project ECHO model, launched in January as the first Montana-based hub. Project ECHO, Billings Clinic is utilizing this model to establish a collaborative and peer support for addiction and behavioral health clinicians working within the Department of Corrections to care for offenders who are incarcerated or transitioning back into the community.
• Reducing readmissions in rural settings using a model based on the Camden Coalition of Healthcare Providers. This model focuses on patients known as “super-utilizers” of the health care system. One percent of these patients can account for more than 20 percent of total health care expenditures. They usually have multiple chronic conditions, emergency department visits, hospital admissions, mental health concerns, substance abuse concerns and/or complex social barriers to receiving care.
• Continuing to educate patients and families so they have the information they need to make informed choices. Patient and family engagement should be the cornerstone of health care quality and reform with the end results being better care, smarter spending and healthier people.
Website:

MPA Healthcare Solutions
Commitment Statement:
MPA Healthcare Solutions is pleased to make a commitment to support the Health Care Payment Learning and Action Network. As long‐time health care outcomes researchers, our team strongly supports the “Better, Smarter, Healthier” alternative payment model Medicare goals announced by Secretary Burwell. MPA understands that many organizations are committed to these principles, but may not yet have sufficient infrastructure to participate in alternative payment models. In order to accelerate adoption, MPA commits to offering the following essential analytic services to support providers and payers in the transition from fee‐for‐service to alternative payment models:
- Clinically‐appropriate eligibility determinations;
- Risk‐adjustment of patient populations;
- Validation of administrative data models using EHRs and other clinical data sources;
- Development and validation of new metrics to help providers measure clinical outcomes;
- Tools to monitor efficiency and effectiveness improvement interventions;
- Provider education on alternative payment model implementation;
- Development and dissemination of rigorous methods to achieve the above goals, within the peer‐reviewed scientific journal literature
MPA currently offers the above services to support alternative payment model implementation, and we commit to continuing to offer this suite of services to an expanding group of providers. We have also set the goal for 2016 to offer our first concurrent risk‐assessment tool to support decision support for providers caring for patients under population‐based payment contracts. We understand that timely data on patient risk is a foundation for care redesign efforts prompted by alternative payment models, and are excited to develop enhanced tools in this critical area. MPA also commits to maintaining a strong research and development program, as we recognize that only by engaging in a robust dialogue about appropriate methods can we develop tools that help payers and providers make improvements to the health care system that above all serve the best interests of patients. We have set the ambitious goal to publish ten new studies on health care outcomes measurement in the next two years (by 2018), and are thrilled to share that we are already making significant progress toward that goal with 3 new peer‐reviewed journal publications in 2016.
Drawing on our experience as an independent third‐party providing analytic infrastructure to both providers and payers, MPA:
- Agrees to work with Network participants to establish standard definitions for alternative payment models;
- Supports measurement of progress towards goals set by HCPLAN members on behalf of the U.S. health care system;
- Commits to reporting progress towards goals for alternative payment models.
Website:

National Kidney Foundation
Commitment Statement:
The National Kidney Foundation (NKF) is pleased to be a committed partner of the Healthcare Payment and Learning Action Network (HCPLAN). Approximately, 26 million Americans have Chronic Kidney Disease (CKD), but most – 90% – don’t know they have it. CKD is the 9th leading cause of death in the United States and increases the risk for heart attack, stroke, and progression to permanent kidney failure known as ESRD. The U.S. Government spends nearly $100 billion on the care of individuals with CKD.
NKF is committed to fostering patient-centered care for individuals with CKD by transforming healthcare delivery to align with earlier identification and treatment, affording patients the opportunity to engage in self-management and shared decision making. NKF is accomplishing this through its CKDintercept initiative, which works with primary care practitioners, healthcare payers and patients to provide the knowledge and tools to alter CKD outcomes, improve patients’ quality of life and have an impact on CKD healthcare spending nationwide. To support this initiative, NKF is working to develop recommendations for a Patient-Focused Kidney Care payment model that will align payment with delivering earlier, better, CKD care. NKF is leveraging the work and tools of the HCPLAN as it builds this payment model.
Website:

National Partnership for Women & Families
Commitment Statement:
We will broadly disseminate information that helps patients and families understand and engage effectively in these new care models; we will raise awareness about the positive impacts of these new models; and we will promote ways for providers to engage patients, families and advocates as co-creators of patient and family-centered care.
Website:
National Partnership for Women & Families
Press Release:

National Rural Accountable Care Consortium
Commitment Statement:
As an organization that is currently leading more than 10,000 small practice and safety net clinicians in America’s smallest and most remote communities, we are in full support of the LAN and CMS’s goals to tie 50% of payments to alternative payment models and CMS’s goal to tie 90% of all traditional Medicare payments to value and quality by 2018.
Our specific goals include:
- Provide education, technical support, and assistance to 17,000 clinicians to improve quality and lower cost.
- Graduate 75% of our Practice Transformation Network clinicians into value-based payment models, including ACOs, by 2018.
- Provide the infrastructure and support to establish state-based, provider-owned, Clinically Integrated Networks (CINs) to assist independent practices in accessing value-based contracts with Medicaid and Commercial Payors.
- Improve primary care quality measure performance by 10% by helping practices implement robust prevention and wellness programs.
- Reduce costs by 10% by reducing unnecessary utilization by helping practices implement robust chronic care management programs.
Website:

National Safety Net Advancement Center (SNAC) at ASU School of Medicine
Commitment Statement:
The National Safety Net Advancement Center (SNAC) at Arizona State University School of Medicine is excited to be a committed partner of the Health Care Payment Learning and Action Network (LAN). Over the next year, SNAC will disseminate LAN’s mission and goals in the following ways:
- SNAC will share relevant LAN resources on its online resource center (safetynet.asu.edu).
- SNAC will incorporate the LAN APM framework, and other LAN content, into original materials produced by the center.
- SNAC will fund 6 safety net organizations to pursue payment and care delivery implementation projects. LAN concepts will be incorporated into the selection of grantees.
- SNAC will lead 6 virtual learning collaboratives consisting of 56 health care safety net participants. LAN resources will be incorporated into the learning collaboratives.
Website:

Network for Regional Healthcare Improvement (NRHI)
Commitment Statement:
The Network for Regional Healthcare Improvement (NRHI) is a network of 35 Regional Health Improvement Collaboratives (RHICs) throughout the country. RHICs have been working for years in their communities to advance alternative payment models by adopting a multi-stakeholder, multi-payer approach.
NHRI makes the following commitments in support of APM adoption:
- To continue to provide leadership on the Physician Focused Payment Model Technical Advisory Committee established by MACRA
- To continue to support and elevate Regional Health Improvement Collaboratives (RHICs) in their ongoing work with local providers, purchasers, patients and payers to advance multi-payer payment reform
- To continue to provide leadership by serving on the LAN Guiding Committee, promoting and sharing LAN recommendations among our membership and facilitating comments on white papers
NRHI supports and elevates its national network of regional collaboratives through its events and initiatives. For example, NRHI convenes local leaders – employers, providers, patients, and plans – to collectively identify and address barriers to moving from volume to value. Specifically, NRHI has hosted three National Payment Reform Summits over the years, resulting in concrete recommendations from multi-stakeholder participants. In partnerships with seven RHICs, NRHI has been helping to advance measurement and reporting of total cost of care (TCoC) at the practical level – a critical milestone for achieving population-based or global payments. As such, NRHI’s priorities and initiatives are consistent with the direction of the LAN and APMs.
Website:

New Hampshire Department of Health and Human Services
Commitment Statement:
Small states are uniquely positioned to bring stakeholders together. New Hampshire’s SIM model, working with over 1,200 stakeholders, recognized that moving from volume to value required a new infrastructure that included the integration of social networks and community into health care delivery, strong health information exchange and payment reforms. With a solid commitment to innovation and public service, the Department of Health and Human Services is using Medicaid waiver authority to assimilate these changes into regionally integrated physical health, mental health and substance misuse services. By 2020, the NH Medicaid program will move 50% of its Medicaid payments from its current mix of Category 2 (fee-for-service with some links to quality and value) to a mix of Category 3B (APMs with Upside Gainsharing/Downside Risk) and Category 4 (Population-Based Payments). NH will continue to work collaboratively with its Integrated Delivery Network partners and its Medicaid managed care partners to design and implement the Alternative Payment Model.
Website:

New York State of Health
Commitment Statement:
New York State has set a goal to link 90% of Medicaid managed care contractual payments to value-based payment (VBP) agreements by the end of 2019, and within that 90%, to link 70% of payments to risk-sharing VBP agreements.
Website:

Ohio, State of
Commitment Statement:
80-90% population of Ohio in some VBP model (combination of episode and population-based payment within 5 years.
Website:

Omada Health, Inc.
Commitment Statement:
The Omada Program is a digital therapeutic based on the Center for Disease Control’s (CDC’s) National Diabetes Prevention Program (DPP), designed with the goal of the prevention of obesity-related chronic diseases. Through an engaging digital experience, participants focus on the goals of losing body weight and increasing physical activity.
Omada ties all reimbursement/payment to engagement and participant outcomes in the program. After one initial reimbursement when the patient initiates the program, Omada’s monthly revenue is solely based on the percent of weight loss achieved by that participant in that month. There are no other charges for any element of the program.
Omada provides a valuable tool to organizations engaged in APMs by allowing them to address a population most likely to drive healthcare spending in the very near future. These individuals, already at the tipping point of diabetes, will soon be among the highest utilizers of healthcare resources. DPP’s focus on behavior change – diet, exercise, sleep, and stress – to support weight loss is important given the proven, direct relationship between weight loss, biomarker improvement, and chronic disease risk reduction. Omada enables organizations to intervene with these individuals before they develop chronic conditions.
Actions:
- Drive value based reimbursement models for digital health.
- Apply and advocate for medical coding that supports alternative payment models.
- Support APM by enabling health systems and payers to reduce costs associated with the development of chronic disease.
Commitments:
- Educate members/stakeholders/consumers on the importance of APM adoption
- Provide written and technical resources and assistance in support of APM adoption
- Spread best practices around APM adoption
- Encourage business associates to operate under value-based payment arrangements/APMs
- Influence policy makers regarding the merits of APM adoption
- Invite LAN experts to speak at meetings/events
- Share LAN materials and information
- Encourage partners and stakeholders to provide input into LAN activities
- Provide leadership on and participation in LAN committees and workgroups
Website:

Oncology Hematology Care
Commitment Statement:
OHC participates in multiple APMs, including three featured in the Addendum to the Alternative Payment Model Framework White Paper. At this time, OHC has 21% of payments tied to APMs in Categories 3 and 4; OHC has 63% of payments tied to APMs in categories 2C through 4.
In order to reach our goal of having 50% of payments tied to APMs in categories 3 and 4 by 2018, OHC has applied to the CMS Oncology Care Model, with letters of support from Aetna, Anthem and Humana. In order to expand even further in application of APMs, OHC will reach out to state agencies to develop an oncology-specific APM for Medicaid.
Practice goals (% payments tied to APMs by category)
Year Category 2C-4 Categories 3-4
2016 63% 21%
2018 85% 50%
2020 90% 60%
OHC believes that achievement of these goals requires a shared commitment from practices, employers, managed care organizations and government agencies. OHC will do its part, as a committed partner of the HCP LAN, to develop and promote value-based care in government and private health plans.
Website:

Optimity Advisors
Commitment Statement:
Optimity Advisors is committed to supporting health plans, health care providers, employers and federal and state agencies through their journey to value-based care. We will leverage our international experience with design, implementation and evaluation of new models of care, particularly Category 3 and 4 APMs, to help the LAN community achieve their goals of better health outcomes, improved quality of care, and reduced costs.
Website:
Optimity Advisors

Optum
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020.
Website:

Oregon Health Authority
Commitment Statement:
Oregon is in support of and intends to shift more payments into Category 3 and 4 over time. Currently, approximately 32% of Oregon’s Coordinated Care Organization (CCO) payments to providers fall into Category 2, 3 and 4. Oregon’s SIM grant focuses on innovation in three areas:
Payment Models, tested at two levels:
• Global budget for CCOs
• A “starter set” of promising alternative models for provider payment and models that focus on the value, rather than the volume, of services provided.
Innovation and Rapid Learning, which provides:
• Resources and technical assistance to CCOs
• Facilitated learning collaboratives and rapid improvement cycles
• Promotion of health equity across sectors and payers including private payers, long-term care, community health, and education systems
Delivery Models
• Evaluation of methods for integrating and coordinating between primary, specialty, behavioral and oral health
• Improvement of community health through promotion and prevention activities
• Support CCOs’ collaboration with long-term care, community health and social services
Website:
Media:
Oregon selected to participate in Comprehensive Primary Care Plus initiative

Pacific Business Group on Health
Commitment Statement:
1. Accelerate the adoption of effective ACO models by health plans, providers, and purchasers. In 2016, leverage PBGH’s ACO learnings and best practices to influence national policy, and develop an ACO action plan by testing models for how PBGH can accelerate adoption of effective ACO models. Nationally disseminate the PBGH guidebook on ACO best practices and test at least three mechanisms for accelerating adoption of effective ACOs.
2. Create and spread approaches, in payment and delivery, to improve care and reduce inappropriate services for patients and issues incurring high costs for our members (e.g., maternity, medically complex).
a. Expand the Transform Maternity Care program. In 2016, secure commitments from California hospitals to participate in learning collaboratives representing 25% of births. Obtain commitments from 5 purchasers to integrate PBGH-endorsed maternity metrics into health plan contracts by 2018.
b. Expand PBGH’s high-cost care models nationally. Engage five non-California regions around high-value maternity care and obtain commitment from one regional partner outside of California to implement elements of the PBGH maternity model in 2016. Spread adoption of common care elements for high-cost patient populations.
3. Accelerate the adoption of bundled payments by health plans, providers, and purchasers in 2016. Create the foundation for broad adoption of bundled payments and gain commitment of purchasers to adopt PBGH bundled payment recommendation. Specifically, gain commitment of 15 purchasers to implement bundled payment program by 2018 that meets PBGH criteria/standards.
4. Develop and spread best practices for payment and delivery reform among purchasers nationally. In 2016, launch Purchaser Value Network. Meaningfully engage at least five regional purchaser coalitions and associations, 50 individual companies and five state purchasers.
5. Increase the number of PBGH members adopting value purchasing and APMs. Work with PBGH members to establish, monitor and achieve individual and collective targets for value purchasing and APM adoption. In 2016, produce an annual report of PBGH member organizations’ adoption of value purchasing and APMs.
Website:
Pacific Business Group on Health

Paradigm Provider Partners (P3)
Commitment:
P3 seeks to accelerate advanced payment model adoption and align incentives to make health and health care safer, more effective, more efficient, more equitable and accessible, and at a reasonable cost. Using our model of forming and supporting physician-led Population Health Plans (PHP) with operating infrastructure, we have set a goal to convert 400 physicians to Category 4 APMs by July 2017.
Website:

Partners Healthcare
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020.
Website:

Patient Advocate Foundation
Commitment Statement:
In order to increase the LAN goal of adoption of alternative payment models (APMs) and to incentivize quality and value over volume, The Patient Advocate Foundation (PAF) believes patients need to play a central role in defining value and quality in health care. At PAF, we help patients overcome multiple barriers as they seek access to their health care and we carefully document the nature of the hurdles encountered and what was done, or could not be done, to deliver quality care.
PAF continues to take a leadership role in securing the best information on how patients interact with their health care. To that end, PAF has launched the Consumer-Based Cancer Care Value Index (CCCVI), a patient satisfaction survey tool designed to identify variations in the patient care experience and gaps in access to key support services. With this information, patients can help their providers better target the services they need and those that may be lacking in their care.
Our desire is to quickly engage multiple sites across the country to use this tool and then report back the experiences of the patient and what they value in their care and what was missing. The CCCVI provides novel ways of measuring care experience. The goals of the CCVI are:
- To publish our results to understand which aspects of cancer care that are misaligned with patients’ values, what these may be and which are significantly associated with worse self-reported mental and physical health outcomes
- A secondary goal is to inform future research to investigate whether prospectively providing cancer care that better aligns with patients’ values leads to better mental and physical health
- A final goal is to take what we learn in the oncology setting and apply this to other disease areas
The CCCVI results can be used as a tool to build models in Category 3 (FFS Architecture) to incent and or reward care that address what an oncology patient values as demonstrated by the results obtained using the CCCVI. While the tool is focused on the care oncology patients receive, the site of care may well be independent, which means the results are applicable to either a primary care or specialist’s site.
As more data is collected and the dataset becomes richer across a larger oncology patient pool, it is conceivable that a population-based reimbursement model that focuses on incenting and rewarding care based on what a patient values can be developed .
Website:

PatientPing
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020.
Website:
Press Release:

Pennsylvania Department of Health
Commitment Statement:
In the face of rising health care costs, Pennsylvania aims to accelerate the shift from volume to value-based payment models. The current status of payment in Pennsylvania is a mix of Category 2 (fee for service with a link to quality & value) and Category 3 (APMs built on fee-for-service architecture). Pennsylvania will join federal efforts in establishing a four-year goal to shift the payment mechanisms across the commonwealth to ones that reward positive, sustainable outcomes versus ones that incent higher patient volume. The final targets will be set in late 2016 based on research currently being conducted by Catalyst for Payment Reform, a non-profit think tank devoted to accelerating the adoption of value-based payment mechanisms. To achieve this goal, Pennsylvania’s value-based payment strategy will include both population-based payment models and episode-based payment models, that is, shift payment methodologies to Categories 3 & 4.
Website:

Pioneer Health Alliance
Commitment Statement:
Pioneer Health Alliance has committed itself as an organization to moving from FFS to value by aligning 80% of our government and non-government payor agreements with some form of population health payment model by the end of 2017 (realizing this was a lofty goal, we felt it could be attained by emphasizing collaboration and partnerships with internal and external resources). This initiative was included in our strategic plan in November of 2014, and has been gaining momentum since its launch January 1, 2015. We also committed in January of 2014 to developing and implementing a MSSP ACO specific to rural health and rural communities, which we launched PY1, January 1, 2015.
Website:

Premier
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020.
Website:

Primary Care Partners
Commitment Statement:
For 50% of revenue or patients by 2016 and 70% by 2018 to have some component of alternative payment model.
Website:

Priority Health
Commitment Statement:
Priority Health has adopted a progressive value-based payment strategy, with a goal of moving 75% of payments into APMs by 2021, focusing on development of clinical and contracting strategies.
Goals:
- Priority Health intends to achieve allocation of 75% of payments in Category 3 or 4 APMs by 2021
- Adopt APMs that support patient focused care
- Develop a value-based payment strategy that is physician informed and led
Actions:
- Participation in primary care models including CPC+
- Strengthening of specialty engagement through programs such as episode-based payments
- Development of upside and downside risk sharing strategies
Website:

Privia Medical Group
Commitment Statement:
Privia Medical Group is one of the largest clinically integrated, high-performance networks in the nation, currently operating in 6 states with over 1,400 providers and caring for over 3 million patients. Privia Medical Group is supported by Privia Health LLC, a purpose-built, physician-led national practice management and population health technology company that partners with leading doctors to keep people healthy, better manage disease, and to reward providers for delivering high value care. Through its high-performance physician group (Privia Medical Group), accountable care organization (Privia Quality Network) and population health management programs, Privia Health is committed to supporting its more than 1,400 providers in the shift to value-based reimbursements in Category 3 and 4 APMs. Privia works in close partnership with forward-thinking health plans and national payers to better align reimbursements to quality and outcomes.
Website:

Qualis Health
Commitment Statement:
As a QIN-QIO, we will support healthcare organizations as they participate in APMs. We will also educate delivery systems not currently in an APM about participating, and encourage them to engage. We will measure our progress by tracking the number of providers/practices that we touch with our technical assistance and how many have actually participated in an APM because of our assistance. We will conduct this work over the next three years.
Website:

Rhode Island, State of
Commitment Statement:
30% of purchasing in value based payment by 2016; 50% by 2018.
Website:

Rite Aid
Commitment Statement:
- Educating our associates about the use of alternative network options that promote improved health outcomes and lower health care costs. We are working with our benefit administration partners to have more than 50 percent of our company and associates’ medical spend supported by health care access through alternative models by 2018.
- Developing unique and innovative programs that aim to achieve many of the same goals as value-based health care, like improving the health of our patients while avoiding costly hospitalizations. A great example is Rite Aid Health Alliance, our integrated delivery model in which Rite Aid pharmacists and health coaches partner with medical providers to help patients with one or more chronic diseases better manage their conditions.
- Positioning our 11,000 pharmacists to deliver a higher level of care to the communities we serve. This includes providing a wide variety of immunizations and additional targeted medication therapy management interventions focused on appropriate medication use, improving compliance, and closing gaps-in-care. This year, each Rite Aid pharmacy will be concentrating on clinical quality performance measures tied to the STAR ratings measures.
Website:
Press Release:
Rite Aid to Participate in Health Care Payment Learning and Action Network

Rocky Mountain Health Plans
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
Website:

Saturn Care
Commitment Statement:
Saturn Care is committed to providing technology and services that enable primary care teams to extend their capacity and capability for comprehensive management of some of their most challenging populations – those with diabetes and other chronic disease. Our CDMP product is specifically designed to help primary care practices succeed in managing their diabetes population under Category 2, 3 and 4 contracts, first by meeting the needs of the doctor, care team and patient and second by setting per-patient per-month pricing as a share of revenues received by the practice under different APMs CDMP has been shown in clinical studies to improve both clinical and behavioral patient outcomes, which is essential to provider success under alternative payment models.
Actions:
- Product/service designed and priced to support value-based care
- Align pricing with providers’ APM payments
Key Activities:
- Encourage business associates to operate under value-based payment arrangements/APMs
Website:

SelectHealth
Commitment Statement:
SelectHealth is pleased to participate in the Health Care Payment Learning and Action Network (LAN), and supports the LAN’s mission to accelerate Alternative Payment Models (APM). The LAN’s mission aligns with our Shared Accountability model designed to improve population health, deliver consistent evidence based care, and make health care more affordable. A key strategy in our model is aligned financial incentives, and we are committed to having 60% of all insured member enrollment in a shared-risk payment model by 2020 (Category 3 and 4 APM). SelectHealth participates in the LAN national APM data collection effort, and will use this as a methodology to measure progress.
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The Sequoia Project
Commitment Statement:
The Sequoia Project supports the nationwide shift toward alternative payment models by enabling critical health data sharing connectivity across the health care continuum, which is essential for success in value-based payment environments, as demonstrated by Intel’s Connected Care. Our goal is to enable health data sharing for at least 60% of U.S. hospitals and more than 10,000 clinics by the end of 2017. In addition to supporting connectivity initiatives, The Sequoia Project continues to identify and solve non-technical barriers to seamless, secure health data sharing, such as governance and trust issues, contributing to the sustainability of local or regional alternative payment initiatives within the national context. We will also continue to partner with purchasers seeking connectivity for care coordination and efficiency across their diverse systems.
Website:
The Sequoia Project
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SSM Health
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020.
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Suncoast RHIO
Commitment Statement:
Our goals cover educating our clients; informing new clients; announcing news to all healthcare organizations we come across; signing up clients to APMs or advising how; working with our State Agencies in Florida; working with medical societies; working with vendor associations; and informing consumers.
Suncoast RHIO commits to:
1. Educate providers – In 2016, we will deliver 5 presentations via multiple channels with feedback loop. These will be conducted at least quarterly.
2. Educate consumers – Distribution of printed and electronic materials (presentations, meetings, flyers, website content) to 2 designated zip codes per month.
3. Increase provider client base related to APM – A 20% minimum increase in a related revenue-generating activity of APM business booked to Suncoast RHIO in 2016, to be measured on a quarterly basis.
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Texas Children’s Health Plan
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
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ThedaCare Center for Healthcare Value
Commitment Statement:
The ThedaCare Center for Healthcare Value’s mission is to redesign three interdependent components of the healthcare industry which will result in improved value for patients. We will accomplish this by collaborating with patients and leaders in the provider, employer, insurer, and government communities to create:
- Delivery of care designed around the patient
- Payment and incentives based upon value and outcomes
- Transparency of performance (quality and cost) throughout the healthcare system
Our role in this nationwide journey includes helping leaders learn, share and connect around healthcare value. We commit to:
- Informing 100% of our Healthcare Value Network (HVN) and Clinical Business Intelligence Network (CBIN) members (currently 83 organizations) about the LAN goals and the APM Framework through our monthly newsletters and a webinar to HVN and CBIN by September 30, 2016
- Conducting a survey with our Network members to gather data to understand their APM work, how it links with delivery reform (lean transformation work), and how we can cross-pollinate the learnings amongst our Network members to further the adoption of APMs
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Trinity Health
Commitment Statement:
(Health Care Transformation Task Force): We are committed to rapid, measurable change, both for ourselves and our country. We commit to having 75 percent of our respective businesses operating under value-based payment arrangements by 2020.
Website:

Tucson Medical Center
Commitment Statement:
Tucson Medical Center (TMC) with Arizona Connected Care (ACO) has been engaged in value-based contracts (APM category 3 and 4) since 2012. We have four contracts in 2016: two Commercial upside-only contracts, one MSSP track 1 and one Medicare Advantage (dual risk). Tucson Medical Center began a second ACO relationship with Abacus Health Arizona Community Physicians on January 1, 2016. Tucson Orthopedic and Tucson Medical Center participate in the voluntary Bundled Payment Initiative with Joint Replacement since 2015. Tucson Medical Center was a founding member of the Health Care Transformation Task Force. TMC also has a successful self-funded health care policy (APM category 4) for its employees. A significant percent is dedicated to Health and Wellness.
Tucson Medical Center has the transformation goal of 75% value based contracting by 2020. The organization with its physician partnerships strongly supports the triple aim.
Goal will be measured yearly. Metrics include number of programs and percent of contracting. Progress to the goal will be displayed.
Website:
Tucson Medical Center (TMC)

United Healthcare
Commitment Statement:
“United has set a goal of having in excess of 60% of payment in value based contracts by 2018.“
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University of Arizona Health Plans
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
Website:

University of Iowa Health Alliance
Commitment Statement:
UIHA ACO intends to support APMs by continuing to expand our Category 3 value-based presence in Iowa through:
• expanding the number of lives covered by value-based agreements,
• continuing to develop our value-based capabilities,
• expanding the types of value-based arrangements, and
• supporting state and federal policy change that expand and grow value-based policy and programs.
Website:

UPMC Health Plan
Commitment Statement:
By 2020, UPMC Health Plan’s goal is to have 75% of total spend across all lines of business in Category 3 or 4 alternative payment models, with our shared savings arrangements with primary care physician and specialty practices evolving to shared risk with robust quality standards.
Website:
Media:
Using an Alternative Payment Model to Reduce Hospitalizations

Vanderbilt University Medical Center
Commitment Statement:
Vanderbilt University Medical Center is committed to increasing the percentage of value-based care delivered by the Health System to equal or exceed the SE Regional average.
Website:

Vizient
Commitment Statement:
Vizient believes that by bringing together groups of diverse health care stakeholders and providing them with knowledge and access to other likeminded individuals that we will be able to accelerate the transition to new models of care and the alternative payment models necessary to support them. To that end, as a Committed Partner Vizient will commit to take the following actions to help advance the objectives of the Health Care Payment Learning and Action Network:
1) Vizient will use the resources it has available, particularly in the areas of education, broadcasting and networking, to raise awareness among clinicians, administrators, and other health care professionals of developments and accomplishments related to value-based payments and alternative payment models. We propose to use our VHA TV studio to broadcast at least one program each year on payment transformation/alternative payment models as well as periodic webinars and other educational forums.
2) Vizient will convene its member organizations across the country, as needed, to obtain feedback on important proposed policy/operational models and will share that feedback with CMS and the Health Care Payment Learning and Action Network in order to guide the further development and dissemination of value-based payment structures and alternative payment models.
3) Vizient, through its Practice Transformation Network (PTN) within the CMS Transforming Clinical Practice Initiative (TCPI), will work with our participating clinicians (6,000 currently; 20,000 target) to help them transform their practices to achieve the Fifth Phase of TCPI Transformation – “thrive as a business via pay-for-value approaches.” We will “graduate” participating clinicians from fee-for-service models to alternative payment models consistent with the expectations CMS provided all PTNs as a condition of award. We believe at least 50% of current clinicians will be operating under an alternative payment model by the end of the program (2019).
We believe these actions, together with the leadership role that Vizient plays in the health care ecosystem, will help advance the transformation of the health care payment system to one that reflects and rewards value over volume and innovation over the status quo. Vizient will be honored to work with CMS, the Health Care Payment Learning and Action Network and other Committed Partners to bring about better care for the individual, better health for communities and smarter spending on health care expenditures.
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Walgreens
Commitment Statement:
We will be educating our employees on the benefits of alternative payment models. Walgreens offers a full range of integrated services and solutions to improve outcomes for our employees and patients while lowering overall costs. Pharmacies and retail clinics can, and should, play a role in future of alternative payment models.
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Walmart
Commitment Statement:
At Walmart, we are working toward goals that are aligned with those of your Administration on payment reform through direct contracting efforts and bundled payments. We are also committed to multi-stakeholder initiatives such as the one in Arkansas and the effort in Colorado. All of us moving in the same direction will send a clear message and make it easier for the system to transform.
Website:

Washington, State of
Commitment Statement:
To have 80% of all state health care purchasing value-based by 2020.
Website:

WellCare
Commitment Statement:
We support the LAN’s goals of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018. We commit to help measure progress toward these goals by participating in the LAN’s nationwide data collection effort. For Commercial, Medicaid and/or Medicare Advantage plans, we will participate in a quantitative data survey and categorize payments according to the APM Framework.
Website:

Westchester Health
Commitment Statement:
Westchester Health is committed to improving population health and expanding our involvement in alternative payment models, likely advanced primary care medical homes, or as we grow possibly an Accountable Care Organization over the next several years. We are enthusiastically embracing alternative payment models to achieve the goals of 30% value based contracting in 2016 and 50% by 2018.
Website:

WL Gore and Associates
Commitment Statement:
For more than 50 years, and with more than 40 million innovative medical devices implanted, Gore has thrived by providing its customers with high-value products that enhance the quality of life. The evolving value-based healthcare environment creates an imperative to measure and improve quality of care. It is our commitment to partner and participate in activities and initiatives which focus on value, quality, improved outcomes and shared decision-making between providers and their patients.
A commitment to innovation shapes everything we do. This core principle aligns with the partnership necessary to accelerate transition towards APMs.
Actions:
- Partner in the development of Quality Measures.
- Engage in activities that promote appropriate implementation of Episodes. For example, Gore intends to use quality and performance assessments of our devices, in part, to inform a variety of Measurement parameters, such as CMS’s Aortic Aneurysm Episode.
- Promote initiatives that focus on value, quality and improved outcomes. Gore, as a qualified repository of significant clinical data, can inform the work of clinicians to develop Quality Measures which more precisely demonstrate how the use of medical devices in procedures impacts value, quality and improves outcomes. Ever respectful of the implications and limitations on industry engagement, Gore is currently exploring ways in which we can collaborate with the clinician community to accomplish these goals.
Commitments
- Educate members/stakeholders/consumers on the importance of APM adoption
- Provide written and technical resources and assistance in support of APM adoption
- Spread best practices around APM adoption
- Encourage business associates to operate under value-based payment arrangements/APMs
- Influence policy makers regarding the merits of APM adoption
- Invite LAN experts to speak at meetings/events
- Share LAN materials and information
- Encourage partners and stakeholders to provide input into LAN activities
Website: