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Date/Time
Date(s) - Tuesday, December 01, 2015, 2:30 PM - 3:30 PM

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Objectives for the Meeting

  • Gain Guiding Committee input on key issues related to each of the three LAN Work Groups (WGs)
  • Begin to discuss cross-cutting issues that impact the work of multiple LAN WGs
  • Introduce discussion of LAN contribution to advancing performance/quality measurement for Alternative Payment Models (APMs)
  • Plan for how/when the Guiding Committee will provide input as products are drafted, finalized, and prepared for release over the next 2-3 months, and decide if an additional meeting in early January is needed

Agenda

  • Welcome and Opening Comments – Lew Sandy
  • Review Work Product Outline and Format – Lew Sandy, Tanya Alteras, Karen Milgate
  • Discuss Issues for Further Refinement – Lew Sandy
  • Discuss Next Steps in Sprint Development – Lew Sandy, Anne Gauthier 

Summary

On December 1, the CEP Work Group held a virtual meeting to continue developing a set of recommendations and options to facilitate adoption of joint replacement episode payment. Hip and knee replacement is a priority topic for the Work Group, given the high volume of surgeries performed each year. The Work Group walked through a draft document that included preliminary recommendations from the November 16 in-person meeting and offered feedback that will help shape the format of the paper, with a goal of creating a product that identifies not only a potential road map for joint replacement but also elements of episode design that may be common across multiple conditions or procedures. Some of these design elements include start point and length of each episode, relative levels of accountability and risk involved, strategies for establishing target price and benchmarks, appropriate quality metrics, and data systems needed to bring episode payments to scale. Underlying all of these design elements is the need to ensure that episodes support better quality and outcomes for patients.

Download Full Summary

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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