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Date/Time
Date(s) - Tuesday, February 02, 2016, 1:30 PM - 2:30 PM

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Objectives for the Meeting

  • Develop consensus on how to address and revise the Elective Joint Replacement White Paper
  • Discuss appropriate next steps based on feedback received

Agenda

  • Discuss Guiding Committee (GC) reactions to the draft Joint Replacement White Paper – Lew Sandy
  • Review the feedback received from the GC – Lew Sandy
  • Gather the CEP Work Group’s detailed reactions to the recommendations as drafted in the second draft White Paper – Tanya Alteras, Karen Milgate
  • Talk about in-person meeting scheduled for February 8 – Lew Sandy

Summary

On the February 2 Clinical Episode Payment (CEP) Work Group bi-weekly call, Lew Sandy, Work Group Chair and LAN Guiding Committee member, shared the Guiding Committee’s feedback on the draft White Paper. Mr. Sandy reported that the Guiding Committee had a positive reaction to the paper, noting specifically that there was support for the principles that the Work Group developed for grounding the episode recommendations. At the same time, the Guiding Committee expressed concern over the length of the paper and provided suggestions for ways to make the document more useful to readers.

CEP Work Group members discussed several issues that should be addressed to refine the White Paper. First, they stressed the need to include specific quality measures that could support joint replacement episode payment, rather than simply describing the characteristics of a quality measure set. Second, they discussed the need for a more detailed description of how shared decision-making tools should be used in order to truly support patients in making informed decisions about whether a joint replacement procedure is appropriate for their goals. This discussion also touched upon the importance of using functional status assessments both before and after the procedure. Finally, the Work Group agreed to develop an appendix that will outline, at a high-level, the way recommendations could play out in various market scenarios. The White Paper will be released for public comment on February 17.

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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