LAN Primary Care Payer Action Collaborative (PAC)
Chair
Charlie Fazio, Senior Vice President and Health Plan Medical Director for HealthPartners
As the LAN pivots from a conceptual learning phase into an action and implementation phase, we want to accelerate payer efforts to transform primary care delivery and payment as part of a new effort called the LAN Primary Care Payer Action Collaborative (PAC).
What is the PAC?
The LAN developed the PAC to serve as an action collaborative for public and private primary care payers participating in multi-payer primary care payment models. The purpose of the PAC is to better enable payer collaboration to develop systems and solutions for implementing sustainable primary care APMs. The PAC provides an environment that offers support and resources for payers who are developing solutions to the challenges that occur in primary care alternative payment model (APM) implementation, including alignment of data sharing systems, quality measurement implementation, and benchmarking and patient attribution strategies. While organizations may be at different stages of designing, testing and implementing APMs, the LAN is committed to working with all participating organizations regardless of where they fit in that spectrum.
The LAN is not able to offer PAC participants any financial support or personalized consulting or technical assistance. This is a voluntary effort and participating organizations are not committed to a broader CMS or private sector initiative.
How are the priorities and milestones determined?
The PAC serves as a resource for both public and private payers participating in multi-payer primary care APM efforts, including payers in the CPC+ regions. The LAN and the CPC+ team at CMMI have developed an initial set of payer milestones or goals in areas such as quality measurement alignment and multi-payer data aggregation for discussion. Payers participating in the PAC will identify their highest priority topics and challenges for which they are seeking support when implementing APMs. The LAN will facilitate a PAC participant-driven agenda to assist the payers with developing and aligning their efforts to reach their goals. PAC participants will decide on the specific priorities for their regional markets that they believe will help them reach the larger, national milestones.
What are the examples of current multi-payer primary care APM initiatives?
The Comprehensive Primary Care Plus (CPC+) initiative was launched by the Center for Medicare & Medicaid Innovation (CMMI) to support the coordination of payment across CMS, private insurance plans, and State Medicaid agencies.
The State Innovation Models (SIM) Initiative was also launched by CMMI and provides states with financial and technical support to develop and test multi-payer health care payment and service delivery models aimed at increasing quality of care and decreasing costs.
Learn more about the PAC (PDF)
Review the LAN’s PAC presentation and materials from the September 9, 2016 CPC+ Payer Summit
For more information about the PAC, contact Lauren Icard, PAC Lead, lauren.icard@us.gt.com
Purchasers
Enabling Organizations | 
Policy Makers
Community Organizations
Emily DuHamel Brower, M.B.A., is senior vice president of clinical integration and physician services for Trinity Health. Emphasizing clinical integration and payment model transformation, Ms. Brower provides strategic direction related to the evolving accountable healthcare environment with strong results. Her team is currently accountable for $10.4B of medical expense for 1.6M lives in Medicare Accountable Care Organizations (ACOs), Medicare Advantage, and Medicaid and Commercial Alternative Payment Models.
Mr. James Sinkoff is the Deputy Executive Officer and Chief Financial Officer for Sun River Health (formerly known as Hudson River HealthCare), and the Chief Executive Officer of Solutions 4 Community Health (S4CH); an MSO serving FQHCs and private physician practices.
Victor is the Chief Medical Officer for TennCare, Tennessee’s Medicaid Agency. At TennCare, Victor leads the medical office to ensure quality and effective delivery of medical, pharmacy, and dental services to its members. He also leads TennCare’s opioid epidemic strategy, social determinants of health, and practice transformation initiatives across the agency. Prior to joining TennCare, Victor worked at Evolent Health supporting value-based population health care delivery. In 2013, Victor served as a White House Fellow to the Secretary of Health and Human Services. Victor completed his Internal Medicine Residency at Emory University still practices clinically as an internist in the Veteran’s Affairs Health System.
Dr. Brandon G. Wilson, DrPH, MHA (he, him, his) joined Community Catalyst as the Director of the Center for Consumer Engagement in Health Innovation, where he leads the Center in bringing the community’s experience to the forefront of health systems transformation and health reform efforts, in order to deliver better care, better value and better health for every community, particularly vulnerable and historically underserved populations. The Center works directly with community advocates around the country to increase the skills and power they have to establish an effective voice at all levels of the health care system. The Center collaborates with innovative health plans, hospitals and providers to incorporate communities and their lived experience into the design of systems of care. The Center also works with state and federal policymakers to spur change that makes the health system more responsive to communities. And it provides consulting services to health plans, provider groups and other health care organizations to help them create meaningful structures for engagement with their communities.
Tamara Ward is the SVP of Insurance Business Operations at Oscar Health, where she leads the National Network Contracting Strategy and Market Expansion & Readiness. Prior to Oscar she served as VP of Managed Care & Network Operations at TriHealth in Southwest Ohio. With over 15 years of progressive health care experience, she has been instrumental driving collaborative payer provider strategies, improving insurance operations, and building high value networks through her various roles with UHC and other large provider health systems. Her breadth and depth of experience and interest-based approach has allowed her to have success solving some of the most complex issues our industry faces today. Tam is passionate about driving change for marginalized communities, developing Oscar’s Culturally Competent Care Program- reducing healthcare disparities and improving access for the underserved population. Tamara holds a B.A. from the University of Cincinnati’s and M.B.A from Miami University.
Dr. Peter Walsh joined the Colorado Department of Health Care Policy and Financing as the Chief Medical Officer on December 1, 2020. Prior to joining HCPF, Dr. Walsh served as a Hospital Field Representative/Surveyor at the Joint Commission, headquartered in Oakbrook Terrace, Illinois.
