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| LAN Summit Event Round-Up | ||||
| Nearly 800 health professionals, including providers, health plans, purchasers, consumer and patient advocates, and state and national government officials, gathered for the 2016 Spring LAN Summit held in Tysons, Virginia on April 25-26. The conference program included more than 40 sessions over the course of two days, with nearly 100 speakers facilitating panel discussions on promising practices to help advance effective alternative payment models (APMs) across the country.
In this special edition e-newsletter, we’re featuring some key sessions from the LAN Summit. Original presentations and select recordings are now available on the LAN Summit website. Also visit us on Storify to see a snapshot of the social media activity from the Summit. Participants highlighted key points and take-aways, offered thoughtful quotes, and shared their experiences through posts online. |
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| Not Your Mother’s Maternity Payment Model | ||||
| The LAN Summit hosted a session on alternative payments for maternity care, entitled Improving the Delivery of Maternity Care via Episode Payment: Opportunities and Challenges, which included panelists Cara Osborne, Baby + Company; Karen Love, Community Health Choice; and Maureen Corry, National Partnership for Women & Families. Panelists shared examples of how APMs are being used to provide high quality, innovative, patient-centered maternity care across the country. The audience provided input on specific concerns related to paying for maternity care through episode payments, including the need to address access to care in rural areas. For more information about the LAN Summit session on maternity care, the slides and recording are now available.
The session also highlighted the Clinical Episode Payment (CEP) Work Group’s draft white paper on maternity care, which provides recommendations for designing episode payments to improve the health of women and babies and reduce costs. The session gave participants an opportunity to provide in-person feedback on the draft. We encourage all interested LAN participants to weigh in with comments online, through Handshake, or via email at paymentnetwork@mitre.org. The deadline to submit comments is Monday, May 23. Your feedback is important to help refine the recommendations, identify gaps in design, and propose solutions. |
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| Performance Measurement for 21st Century Payment | ||||
| The Population-Based Payment (PBP) Work Group facilitated a session, entitled Preliminary Recommendations on Performance Measurement, moderated by Dana Gelb Safran, Blue Cross Blue Shield of Massachusetts and co-chair of the PBP Work Group. Panelists included Jean Moody-Williams, Centers for Medicare & Medicaid Services (CMS); Elizabeth Mitchell, Network for Regional Healthcare Improvement (NRHI) and Guiding Committee member; and Andrew Sperling, National Alliance on Mental Illness (NAMI) and PBP Work Group member.
The session outlined the importance of achieving outcome-oriented performance measurement, especially when managing high-cost patient populations with multiple chronic illnesses. It also highlighted preliminary recommendations from the performance measurement draft white paper, which offers suggestions for how performance could be measured to enable effective population-based payments. The paper allows for payers, providers, purchasers, and patients to be held collectively accountable for ensuring that the health care system delivers the highest possible value. In case you missed the session at the LAN Summit, the slides and recording are now available. We would appreciate your feedback on this draft white paper. Please provide comments by Monday, May 23 by filling out the comment form, or reaching out through Handshake or email at paymentnetwork@mitre.org. |
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| Taking Episode Payment Models to Heart | ||||
| Clinical episode payment models are designed to improve quality, costs, and outcomes by paying for a patient-centered course of care over a specified period of time and across multiple care settings. Patients living with coronary artery disease (CAD), however, experience condition-based care and management over a long, undefined period of time. While the process of developing an episode payment model that does not have neatly defined time periods is challenging, the LAN is pursuing a condition-level episode payment model for CAD in order to move the field forward to improve care for patients with complex conditions.
To help address these challenges, the LAN Summit featured a panel discussion on episode payment models for cardiac care entitled Improving the Delivery of Cardiac Care via Episode Payment: Opportunities and Challenges. Moderated by Jason Wasfy, Massachusetts General Heart Center, panelists included Sarah Burstein, HCI3; and Ed Bassin, Archway Health. The session highlighted the CEP Work Group’s progress in defining CAD care episode payment goals for patients and health systems, while outlining draft recommendations for how to shape episode payment for CAD management. The CEP Work Group design includes a “nested” episode payment for CAD procedures, such as percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). For more information, listen to the session recording. The CEP Work Group draft recommendations for CAD episode payment models will be released and open for public comment on Friday, May 20. |
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| What Purchasers Want (and Need) | ||||
| Purchasers, providers, and plans – despite their differing perspectives – agree that a common language goes a long way to help implement value-based payment models. For purchasers to be fully engaged, common definitions of quality, efficiency, and populations are needed, and the “supply side” must take into account the priorities, parameters, and decision-making processes of the “demand side” – those who are purchasing health care on behalf of their employees.
David Lansky, Pacific Business Group on Health and LAN Guiding Committee member, facilitated What Purchasers Want: A Dialogue Among Purchasers, Providers, and Plans at the LAN Summit. Panelists included Dorothy Teeter, Washington State Health Care Authority and Guiding Committee member; Brian Marcotte, National Business Group on Health; Jordan Asher, MissionPoint Health Partners; Amanda Berra, The Advisory Board Company; and Stephen Ondra, Health Care Service Corporation. |
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| Taking a Team Approach to Successful APM Adoption | ||||
| Sam Nussbaum, chair of the APM Framework and Progress Tracking Work Group and Payer Collaborative, led a plenary discussion at the LAN Summit with CMS and private health plans that had taken part in a pilot to test the LAN’s approach for measuring adoption of APMs across commercial, Medicaid, and Medicare Advantage market segments. The session entitled Measuring APM Adoption Across the Nation included panelists Greg Bowman, Anthem; Chip Howard, Humana; Rahul Rajkumar, CMS; and Patrick Gordon, Rocky Mountain Health Plans. Nussbaum invited each panelist to describe their experience working with APMs and explain why their organization felt it was critical to participate in the Payer Collaborative.
Panelists shared a recognition that in order to achieve shared payment reform goals, both national and local plans have an obligation and role to play in helping to move their communities and the nation forward. Health plans also need a means of generating accurate claims-based data which their providers can use to improve patient care, as well as a variety of effective and comprehensive payment models that support the needs of providers, especially primary care providers. Nussbaum closed the plenary by urging payers in the audience to participate in the LAN’s national survey launching mid-May and to commit to sharing their progress adopting APMs. “We are all on a journey together,” he said. “The only way forward is for us to work together.” |
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| Doing “Whatever It Takes” to Support the Triple Aim through Population-based Payment Models | ||||
| Later this week, the PBP Work Group plans to release updated versions of the patient attribution and financial benchmarking white papers. The papers include feedback from the public comment period earlier this year and offer actionable recommendations that will guide stakeholders in their adoption of APMs.
PBP models also took center stage at the LAN Summit with the plenary, Supporting the Triple Aim: Stakeholder Perspectives on Population-Based Payment Models. Aiming to discuss PBP models from the perspectives of a health plan, public payer, large purchaser, and consumer/patient, PBP Work Group co-chair Dana Gelb Safran facilitated a passionate discussion about PBP model adoption. The panel featured David Lansky, Pacific Business Group on Health; Hoangmai Pham, CMS; and Ann Hwang, Community Catalyst. |
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| Upcoming Events | ||||
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| Case Studies from Provider-Led Organizations | ||||
| Time & Date TBD | ||||
| This virtual presentation will focus on case studies from provider-led organizations that are implementing APMs. Drawn from the experiences of a nationwide network of provider-led risk-bearing organizations in multiple markets, this webinar will focus on best practices related to structuring APMs by highlighting three case studies that represent different types of PBP models. Participants will learn the “do’s and don’ts” of APM contracting, care delivery improvement in complex organization environments, and effective physician engagement. | ||||
| stay tuned for event info |
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| LAN News | ||||
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| Of Interest | ||||
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