Clinical Episode Payment (CEP) Work Group Bi-Weekly Meeting

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Date/Time
Date(s) - Tuesday, November 10, 2015, 3:30 PM - 5:00 PM

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Objectives for the Meeting

  • Introduce work group members to one another​
  • Orient new work group members to the LAN​
  • Discuss charge of the work group​
  • Gather critical input to help shape the work planning ​
  • Review next steps, upcoming events and activities

Agenda

  • Welcome and Meeting Overview – Lew Sandy​, Anne Gauthier​
  • LAN Background and Context​ – Mark Smith​
  • Work Group Charge – Lew Sandy
  • Discussion- Lew Sandy
    • Questions and feedback on the group’s charge​
    • Prioritizing and sequencing the work​
  • Wrap-Up ​– Lew Sandy​, Tanya Alteras​
    • Recap themes​
    • Discuss next steps

Summary

The Clinical Episode Payment (CEP) Work Group held its inaugural teleconference on Tuesday, November 10, 2015 to introduce its members and discuss the CEP Work Group’s charge by the LAN Guiding Committee (GC). GC Co-chair Mark D. Smith introduced new work group members to the LAN, while CEP Work Group Chair Lewis Sandy gathered critical input from members to help shape the planning, next steps, upcoming events, and activities of the CEP Work Group. A clinical episode payment is defined as a reimbursement to a provider on the basis of expected costs for clinically defined episodes that may involve several practitioner types, several settings of care, and several services or procedures over time. The panel discussed the joint-replacement sprint in light of the pending release of Medicare’s Comprehensive Care for Joint Replacement (CJR) payment model, and various elements that are required to establish sound metrics and clinical episode payment recommendations.

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To achieve the goal of better care, smarter spending, and healthier people, the U.S. health care system must substantially reform its payment structure to incentivize quality, health outcomes, and value over volume. The Health Care Payment Learning and Action Network (LAN) was established as a collaborative network of public and private stakeholders, including health plans, providers, patients, employers, consumers, states, federal agencies, and other partners within the health care community.

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