Health Care Payment Learning and Action Network

To help achieve better care, smarter spending, and healthier people, the Department of Health and Human Services (HHS) is working in concert with our partners in the private, public, and non-profit sectors to transform the nation’s health system to emphasize value over volume. HHS has set a goal (PDF) of tying 30 percent of Medicare fee-for-service payments to quality (PDF) or value through alternative payment models by 2016 and 50 percent by 2018. HHS has also set a goal of tying 85 percent of all Medicare fee-for-service to quality or value by 2016 and 90 percent by 2018. To support these efforts, HHS has launched the Health Care Payment Learning and Action Network to help advance the work being done across sectors to increase the adoption of value-based payments and alternative payment models.

If you would like more information or wish to participate in the Health Care Payment Learning and Action Network, please visit the registration web page. The names of registered organizations will be made public.

Background

All alternative payment models (APM) and payment reforms that seek to deliver better care at lower cost share a common pathway for success: providers, payers, and others in the health care system must make fundamental changes in their day-to-day operations that improve quality and reduce the cost of health care. Making operational changes will be viable and attractive only if new alternative payment models and payment reforms are broadly adopted by a critical mass of payers. When providers encounter new payment strategies for one payer but not others, the incentives to change are weak. When payers align their efforts, the incentives to change are stronger and the obstacles to change are reduced.

The Health Care Payment Learning and Action Network will bring together private payers, providers, employers, state partners, consumer groups, individual consumers, and many others to accelerate the transition to alternative payment models.

Initiative Details

The Health Care Payment Learning and Action Network will:

  • 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 how best to analyze data and 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.

All payers, providers, employers, states, consumer groups, individual consumers, and others are invited to participate. Participants will have the opportunity to join workgroups and learning sessions on increasing adoption of alternative payment models and other care delivery models. Most meetings of the Network will occur virtually by teleconference or webinar. In-person meetings will occur in the Washington D.C. area. Information collected during workgroups will be summarized and presented back to all participants in the Network. The Network will be convened by a contractor which will consider the views and recommendations of the Network when performing contracted activities.

Working together, HHS, private sector payers, providers, employers, states, consumer groups, individual consumers, and other partners will help health care payments transition more quickly toward alternative payment models —– a critical step toward better care, smarter spending, and healthier people.

If you would like more information or wish to participate in the Health Care Payment Learning and Action Network, registration is now open. Registered organizations will be made public.

Guiding Committee

The CMS Alliance to Modernize Healthcare (CAMH), operated by The MITRE Corporation, convened the Guiding Committee to provide executive leadership for the Health Care Payment Learning and Action Network. The 24 Guiding Committee members are influential leaders in their fields. They represent diverse stakeholder groups, including providers, health plans, purchasers/employers, consumers/patients, and state, regional, and federal representatives. The Guiding Committee will begin its work by identifying priorities of the Health Care Payment Learning and Action Network to provide practical assistance to the field that are achievable in the next year and laying out a strategy for aligning members and achieving the Network’s goals.

Other Initiatives

The Health Care Payment Learning and Action Network is one part of a larger effort at the Department of Health and Human Services to drive better care, smarter spending, and healthier people by improving the way care is delivered, the way providers are paid, and the way information is shared to support decision-making. For example, to support improvements in care delivery, HHS announced Transforming Clinical Practice Initiative in October 2014—an investment exceeding $800 million designed to support 150,000 clinician practices over the next four years in sharing, adapting and further developing comprehensive quality improvement strategies. To support information-sharing, the Office of the National Coordinator for Health Information Technology released “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap (PDF).” in January 2015. The roadmap will provide a pathway for the public and private sectors to work together to free up data so patients and providers can securely access their health information when and where they need it.

For further information on HCPLAN activities and future events, please visit the new HCPLAN website.

Additional Information