Payment reform is critical to building a health care system that results in better accessibility, quality, affordability, empowerment, and innovation.
The Health Care Payment Learning & Action Network (LAN), is a public-private partnership launched in March 2015 to drive adoption and alignment of Alternative Payment Models (APMs). A report released today by LAN showed that 29% of total U.S. health care payments were tied to alternative payment models (APMs) in 2016 compared to 23% in 2015, an increase of six percentage points. The goals of the LAN were to tie 30% of total U.S. health care payments to APMs by 2016 and 50% by 2018.
The findings reveal actual 2016 health care spending from four data sources: the LAN, America’s Health Insurance Plans (AHIP), the Blue Cross Blue Shield Association (BCBSA), and the Centers for Medicare and Medicaid Services (CMS) across commercial, Medicaid, Medicare Advantage, and fee-for-service (FFS) Medicare market segments, and then categorize them according to the four categories of the original LAN APM Framework.
The LAN APM Measurement Effort determined the following results:
* 43% of health care dollars in Category 1 (e.g., traditional FFS or other legacy payments not linked to quality)
* 28% of health care dollars in Category 2 (e.g., pay-for-performance or care coordination fees)
* 29% of health care dollars in a composite of Categories 3 and 4 (e.g., shared savings, shared risk, bundled payments, or population-based payments)
Market Insider quotes Mark McClellan, Co-Chair, LAN Guiding Committee; Director, Robert J. Margolis Center for Health Policy:
As health care expenditures and capabilities have continued to rise, it’s vital that we find ways to significantly reduce the cost burden for both consumers and the health care system. This measurement effort represents the kind of collaboration between the public and private sectors to make real progress on improving care.
Detailed findings can be accessed via the LAN Website
The LAN has adopted the goal of tying 50% of U.S. health care payments to APMs by the end of 2018.
For more information, go to www.hcp-lan.org.