Microsite page

Nearly one quarter of all US health care payments are already
flowing through alternative payment models

Where does your organization stand?

The Health Care Payment Learning and Action Network (LAN) is measuring nationwide progress toward alternative payment model (APM) adoption as a means to a more effective health care system. As leaders in this space, participating health plans will contribute to that understanding as well as discover how they compare to the nation and their peers.

To participate in or provide feedback on this effort, please contact Cathy Becker

How are health care payments shifting away from traditional fee-for-service arrangements toward alternative payment models (APMs)? Where does the nation stand in APM adoption in the commercial, Medicare Advantage, and Medicaid markets?

Having a common definition of alternative payment is critical to our ability to move forward together. When health plans report payments in alignment with the LAN APM Framework, you gain an accurate understanding of your position in your markets.

The LAN is currently recruiting health plans to participate in the 2017 APM Measurement Effort. Grab a seat at the table as health plans across the country contribute to our understanding of progress in APM adoption. Your participation will inform and bolster our understanding of nationwide progress toward APMs, and thus give you a better idea of where you stand in relation to other health plans.

As reimbursements move away from traditional fee-for-service models toward the adoption of APMs, health plans want a consistent and standard way to measure APM adoption and understand trends. In exchange for your participation, the LAN will provide a benchmarking report based on the data received through the survey to help participants understand how they stack up in the market. This report is contingent on the number of health plans participating in the effort; however, the LAN will provide benchmarking details to the level of granularity possible while still maintaining anonymity for contributing health plans.

For 2017, participating health plans will report total in- and out-of-network health care spending paid to providers through each of the APM Framework categories during 2016 or the most recent 12 months in the commercial, Medicaid and Medicare Advantage markets. The LAN works directly with participants to ensure a clear understanding of how to classify payments in the APM framework. This makes participation as simple and straightforward as possible.

Individual plan data will be kept strictly confidential. It will not be shared with other health plan participants or parties outside of the LAN data collection team. For reporting purposes, individual plan data will be aggregated with data from other health plans.

For more detailed information on the data collection methodology, click here.

The LAN’s APM Framework provides standardized definitions and categories of APMs. The Framework was first published in January 2016 and is currently being refreshed, in part based on feedback from 2016 LAN Measurement Effort participants. Revisions will include minor modifications to category classification that will allow accurate data collection without any additional burden on participants.

The LAN’s first APM Measurement Effort in 2016, which included data on nearly 200 million Americans (67% of covered lives), revealed that 23% of payments made in 2015 were in APM categories 3 and 4.

The 2017 Measurement Effort will provide information on payments made in 2016, allowing for comparison over time and an indication of the movement toward APM adoption.

To participate in the MAC, contact Tanya Alteras, MAC Lead, talteras@mitre.org


Please send us an email and we will get back to you as soon as possible.

Copyright © 1997-2016, The MITRE Corporation. All rights reserved. MITRE is a registered trademark of The MITRE Corporation. Material on this site may be copied and distributed with permission only.

Log in with your credentials


Forgot your details?

Create Account