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Participation MattersWhere Do You Stand?How We MeasureHow You Define APMWhat is the Outcome?

Participation Matters

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 Health Care Payment Learning and Action Network (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. 

 

Where Do You Stand?

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. If enough health plans participate to ensure that the results in each market segment are nationally representative and anonymity can be preserved, it may be possible to provide benchmarking data by line of business.

How We Measure

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.

 

How You Define APM

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.

What is the Outcome?

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.