Health Care Payment Learning and Action Network Is Open for Registration
On March 25, 2015, the Centers of Medicare and Medicaid Services (“CMS”), launched the Health Care Payment Learning and Action Network (the “Network”), an ambitious private-public partnership designed to further move the health care system away from quantity-based care and closer to value-based, quality-driven care.
The Network is being established to “help the U.S. health care payment system meet or exceed recently established Medicare goals for value-based payments and alternative payment methods.” The Medicare goals are as follows: (i) move 30% of Medicare payments into alternative payment models, such as Accountable Care Organizations, bundled payments and advanced primary care medical homes, by 2016; and (ii) move 50% of Medicare payments into alternative payment models by 2018.
Overall, HHS seeks to have almost 90% of Medicare payments tied to quality or value in the next three years.
The Network will serve as a forum where “payers, providers, employers, purchasers, state partners, consumer groups, individual consumers and others” can discuss the transition toward alternative payment models that maximize value. CMS invites all interested individuals and organizations to register. An independent contractor, funded by CMS, will “act as a convener and facilitator” to support the Network. The contractor will create work groups to identify best practices and implement alternative payment models. As a facilitator, the contractor will “maintain the pace of the Network so that it readily addresses the needs of participants.”
HHS hopes participation in the Network will align different payers’ interests in a way that effectuates a smoother transition away from fee-for-service based care. According to CMS, the Network will perform the following functions:
- Serve as a convening body to facilitate joint implementation of new models of payment and care delivery;
- Identify areas of agreement around movement toward alternative payment models and define how best to report on these new payment models;
- Collaborate to generate evidence, share approaches and remove barriers;
- Develop common approaches to core issues such as beneficiary attribution, financial models, benchmarking, quality and performance measurement, risk adjustment, and other topics raised for discussion; and
- Create implementation guides for payers, purchasers, providers, and consumers.
According to CMS, more than 2,800 entities have joined the Network, with 44 state, payer, health system, corporate, association, and other stakeholder partners already adopting organization-specific goals for alternative payment models. HHS is continually striving to reduce obstacles and create stronger incentives for entities to move toward value-based care. The Network is a “key component of this effort to deliver better care, smarter spending of health dollars, and healthier people.”
Anthony Knapp is a guest contributor to Health Law Gurus™. He received his J.D. from Widener University School of Law, where he was editor of the Health Law Colloquium. He previously clerked in the Philadelphia Court of Common Pleas and worked as a Navigator to facilitate consumer access to health insurance in Delaware.