FACT SHEET
FOR IMMEDIATE RELEASE
February 27th, 2015
Contact: CMS Media Relations
Fact Sheet: Health Care
Payment Learning and Action Network
Working Together
to Move Payment toward Value and Quality in the U.S. Health System
The Purpose of the Health Care Payment Learning and
Action Network
In January 2015, Department of Health and Human Services
(HHS) Secretary Sylvia M. Burwell
announced
an ambitious initiative to move the Medicare program, and the health care
system at large, toward paying providers based on the quality, rather than the
quantity of care they give patient. The Health Care Payment Learning and Action
Network is a key component of this effort to deliver better care, smarter
spending of health dollars, and healthier people.
The Health Care Payment Learning and Action Network
(“Network”) is being established to provide a forum for public-private
partnerships to help the U.S. health care payment system (both private and
public) meet or exceed recently established Medicare goals for value-based
payments and alternative payment models. To help drive the health care system
towards greater value-based purchasing — rather than continuing to reward
volume regardless of quality of care delivered, HHS has set a goal of moving 30
percent of Medicare payments into alternative payment models by the end of 2016
and 50 percent into alternative payment models by the end of 2018. Alternative payment
models include models such as Accountable Care Organizations (ACOs), bundled
payments, and advanced primary care medical homes. Overall, HHS seeks to have
85 percent of Medicare payments tied to quality or value by 2016 and 90 percent
by 2018.
The Network will serve as a forum where payers, providers,
employers, purchasers, state partners, consumer groups, individual consumers,
and others can discuss how to transition towards alternative payment models
that emphasize value. The Network will be supported by an independent
contractor that will act as a convener and facilitator.
- As a convener, the Network contractor
will identify discussion topics and will bring together technical experts
from the payer, provider, purchaser, employer, state, and consumer
communities — creating workgroups that will catalogue best practices and
implementation successes for alternative payment models and other payment
reform.
- As a facilitator, the Network
contractor will provide logistical support to workgroups and help
disseminate best practices to all Network participants.
Open Invitation to Participate in the Health Care
Payment Learning and Action Network
Management of the Health Care Payment Learning and
Action Network
The Network will be
convened by an independent contractor funded by the Centers for Medicare &
Medicaid Services (CMS). The contractor will convene meetings, disseminate
information to Network participants, and lead learning sessions where
participants can share best practices. The contractor will consider the views
and recommendations of the Network when performing contracted activities. The
Network will operate independently of HHS, CMS, and other government entities,
and will work to support the efforts of the participants as a whole.
A Guiding Committee will be created to prioritize
discussion topics and make recommendations to the contractor. Participants of
this Guiding Committee will be drawn from participants in the Network.
Workgroups will be created by the independent contractor in consultation with
the Guiding Committee to address specific topic areas. Participants in
workgroups will be drawn from Network participants. Representatives from HHS
can participate equally on the Guiding Committee and workgroups. Information
will be shared with the entire Network through regularly scheduled webinars and
in-person meetings.
Meetings of the Health Care Payment Learning and
Action Network
Most meetings of the Network will
occur virtually by teleconference or webinar. In-person meetings will occur in
the Washington D.C. area. The frequency of meetings will be determined
by the contractor and informed by the Guiding Committee. CMS anticipates that
there will be at least one meeting of the full Network each year, with
additional webinars and discussions as needed. The Guiding Committee and
workgroups will meet more frequently depending on the topics under discussion. Please join us for live streaming of the kickoff event on
Wednesday, March 25, 2015.
Activities of the Health Care Learning and Action
Network
Workgroup discussion topics will be defined by the
independent contractor in consultation with the Guiding Committee and Network
participants.
The Health Care Payment Learning and Action 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.
Participating in the Health Care Payment Learning
and Action Network
Participants will be expected to actively engage in the
Network by contributing to workgroups, sharing best practices, and learning
from peers.
Stakeholders participating in the Network will be asked to:
- Support national
alternative payment model goals for the U.S. health system that match or
exceed the Medicare fee-for-service goals (30% alternative payment model
penetration by 2016 and 50% by 2018),
- Agree that progress
towards national goals should be measured, and
- Work with Network
participants to establish standard definitions for alternative payment
models.
Within the first six months, stakeholders will be asked to
- Set
organization-specific goals for alternative payment models and
- Participate in reporting
of progress towards national alternative payment model goals.
Dissemination of Findings for the Health Care
Payment Learning and Action Network
The contractor will synthesize and document best practices
across a variety of topic areas. Workgroups will be responsible for sharing
their findings with the contractor to produce ‘best practice’ white papers.
These best practices will inform webinar and in-person meetings where lessons
learned will be shared. The frequency of reports and learning sessions will
depend upon the topics.
We anticipate that the Network will build a repository of
best practice papers for participants and the general public. When payers,
providers, employers, purchasers, states, consumer groups, or individual
consumers want to enter into alternative payment contracts or want to learn
more about alternative payment models, they will be able to quickly obtain
detailed information about best practices and to identify experts who are
willing to share their experiences.
There is no fee to participate in the Network.
Organizations will not receive funding from HHS or CMS for participating in the
Network. Travel and accommodation for in-person meetings will not be paid for
by HHS or CMS.
How to Register for the Health Care Payment
Learning and Action Network
