To help the country transform its care delivery and payment methods to focus on value instead of volume, the U.S. Department of Health and Human Services (HHS) launched the Health Care Payment Learning and Action Network (LAN). The LAN's mission is simple: accelerating the adoption of value-based payment systems and alternative payment models (APMs) while phasing out the traditional fee-for-service model under which "more services lead to higher payments, regardless of health outcomes."
At the LAN's 2016 Spring Summit in Tysons Corner, Virginia, professionals spanning the healthcare continuum – from providers and payers to administrators and local, state, and federal government leaders – shared experiences and lessons learned in developing and implementing APMs.
Onpoint and two of our partnering clients, the Vermont Blueprint for Health and the Health Collaborative of the Greater Cincinnati (Ohio) region, were invited to present on the topic of "Data Infrastructure to Support APMs at Scale," a session moderated by Dr. Karen DeSalvo, a physician and public health expert who serves concurrently as the Acting Assistant Secretary for Health and the Director of the Office of the National Coordinator for Health Information Technology (ONC) at the HHS. The session included presentations by Craig Jones, MD, Director of the Vermont Blueprint for Health; Richard Shonk, MD, PhD, Chief Medical Officer of the Health Collaborative; William Golden, MD, MACP, Medical Director of Arkansas DHS/Medicaid; and Jim Harrison, MHA, FACMPE, President/CEO of Onpoint.
Drs. Jones, Shonk, and Golden each emphasized the importance of active stakeholder engagement across provider organizations, purchasers, and government organizations to ensure their success. While the reporting solutions, performance measures, and dissemination strategies vary across their initiatives, the presenters' message was clear that strong leadership at the grassroots level combined with capable technical partners is key to all.
Harrison's presentation focused on the important foundational elements underlying a reliable data system – what's "under the hood" – those data validation, standardization, and analytic enrichment systems and processes that are essential to accurate and trusted downstream analytics. "Stakeholders of data collection and reporting initiatives, particularly in their earliest stages, take as a given the reliability of data validation and integration systems and, instead, place more value on a flashy front end or business intelligence interface," he noted. "In the end, if rigorous quality assurance procedures are not in place, and end users identify errors in the data, trust and support will quickly be lost."
Together, the presenters discussed how the successful scaling of APMs requires not only a critical mass of data across payers but also the infrastructure and subject matter expertise to effectively process, manage, and report practice results in a timely fashion and in comparison to trusted benchmarks.