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Date/Time
Date(s) - Wednesday, December 16, 2015, 12:00 PM - 1:00 PM

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Objectives for the Meeting

  • Obtain healthcare providers’ perspectives on the LAN

Agenda

  • Opening Remarks and LAN Overview – Anne Gauthier
  • APM Framework Overview – Shari Erickson
  • Facilitated Discussion and Wrap-Up – Paul Harkaway

Summary

On December 16, 2015, the Alternative Payment Model Framework and Progress Tracking (APM FPT) Work Group hosted a provider listening session to gain healthcare providers’ perspectives on the LAN and the Draft APM Framework. Dr. Paul Harkaway from Trinity Health and Ms. Shari Erickson from the American College of Physicians each described the APM Framework, followed by Dr. Grischa Metlay from the Centers for Medicare and Medicaid (CMS) Alliance to Modernize Healthcare (CAMH) who highlighted comments received to date on the Draft APM Framework. The panel discussed provider concerns with the proposed APM Categories, specifically, how or which providers or provider organizations may be best structured under a particular payment model. Concerns were raised about the equitable future of smaller, independent or rural health providers that may not have the resource capacity to perform under APMs. In response, the Transforming Clinical Practice Initiative (TCPI), a program designed to help clinical practices transform towards APMs, was discussed. Questions were also raised about how the Draft APM Framework aligns with current Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and Medicare Advantage programs and initiatives, and also about how the Draft APM White Paper can be further refined to include other non-fee-for-service provider payment structures such as primary risk adjusted capitation.

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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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