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Date/Time
Date(s) - Thursday, October 15, 2015, 12:30 PM - 1:45 PM

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Learning Objectives

  • Hear updates on the activities of the LAN Guiding Committee
  • Learn about a payment reform approach focused on low-income and vulnerable populations in New Jersey

Description

During this webinar, Mark McClellan, the co-chair of the Guiding Committee (GC) of the Health Care Payment Learning & Action Network (LAN) will review the GC’s latest activities, including its most recent in-person and virtual meetings. Dr. McClellan will also review the progress being made toward launching the new Population-Based Payment (PBP) Work Group and Clinical Episodes Payment (CEP) Work Group, both of which will have their kick-off meetings later this month. The webinar will also feature a panel discussion on the payment reform approach used by the state of New Jersey that is focused on serving low-income and vulnerable populations at the state and local level.

Agenda

  • Welcome and Opening Remarks – Anne Gauthier
  • Guiding Committee Updates and Q&A – Mark McClellan
  • Panel: Sharing the New Jersey Medicaid Payment Reform Initiative – Mark Humowiecki, Edith Calamia, Derek DeLia
    • About the state approach
    • Implementing the models locally
    • Lessons learned
  • Questions from LAN Participants – Anne Gauthier
  • Upcoming LAN Activities and Closing Comments – Anne Gauthier, Mark McClellan

Event Recap

A speaker panel was held on October 15, 2015 to discuss the state of New Jersey’s payment reform approach, or demonstration model, that focuses particularly on the healthare challenges of low-income populations. Dr. Derek DeLia from the Rutgers Center for State Health Policy discussed the challenges specific to low-income populations in NJ, and provided an overview of NJ’s demonstration model along with future plans to evaluate and obtain performance feedback on the model. Mark Humowieki of the Camden Coalition of Healthcare Providers and Dr. Edith Calamia of UnitedHealthcare discussed the Camden Accountable Care Organization (ACO) model and strategy, including its challenges and lessons learned. The panelists provided further advice on how other states may successfully implement ACO models. Questions from the panelists included how NJ’s ACO financial model is structured, how pharmacy/prescription benefits are incorporated into the total cost of care within the model, and how certain mental health challenges within low-income populations are addressed within the model.

Q&A Audio Slides

Mark B. McClellan, MD, PhD, serves as Co-chair of the Health Care Payment Learning & Action Network’s Guiding Committee. He is Robert Margolis Professor of Business, Medicine, and Policy at Duke University and the Director of the Duke Margolis Center for Health Policy. Previously he was a senior fellow and Director of the Health Care Innovation and Value Initiatives at the Brookings Institution. A doctor and economist, he also has a distinguished record in public service and in academic research. Dr. McClellan is a former administrator of the Centers for Medicare & Medicaid Services (CMS) and a former commissioner of the U.S. Food and Drug Administration (FDA) where he developed and implemented major reforms in health policy. He is also a former professor of economics with tenure at Stanford University.

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