Alternative Payment Model Framework and Progress Tracking Work GroupSam Nussbaum, MD, Executive Vice President, Clinical Health Policy and Chief Medical Officer at Anthem, Inc., has been appointed to head the Alternative Payment Model (APM) Definitions and Progress Tracking Work Group.

The Work Group is charged with recommending a set of APM terms and concepts to serve as a foundation for the LAN’s work going forward. These terms must be easily understood but also specific enough to be operationally meaningful. In addition, the group will propose an approach for measuring APM adoption across the U.S. health care system that includes clarity on what should be measured as well as a set of categories that enable meaningful reporting. The LAN will measure progress toward APM adoption following the Work Group’s recommendations. The Work Group will be composed of approximately 15 individuals with a variety of pertinent expertise. It will work intensively and is expected to wrap up its task at the end of four months.

An advocate of models that improve quality, safety and affordability, Nussbaum has championed payment reform and measurement initiatives for more than a decade. Under his leadership, the Work Group will embark on its herculean task quickly and efficiently. Nussbaum brings broad knowledge of the health ecosystem from his experience in clinical research and teaching, working on the provider side in a health system, and executive leadership of a major payer, though he will leave his organizational hat at the door when convening the Work Group. He was selected as Chair for his demonstrated ability to bring together the range of perspectives that must inform an approach for measuring progress in APMs. Nussbaum is a member of the LAN Guiding Committee (GC) and will ensure that the strategy and momentum established by the GC continues through the efforts of this first Work Group. The Work Group membership, recruited through applications and referrals from LAN participants, will be announced soon.

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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