Health Care Payment Learning and Action Network Created to Eliminate Barriers to Value-Based Care Transition

Better care, smarter spending, healthier people: The Department of Health and Human Services (HHS) set this goal in its ongoing efforts to transition the nation’s health system to one which focuses on value over volume.

To achieve its larger aim, HHS outlined these yearly goals:

  • Tying 30 percent of Medicare fee-for-service payments to quality or value through alternative payment models by 2016 and 50 percent by 2018.
  • Tying 85 percent of all Medicare fee-for-service to quality or value by 2016 and 90 percent by 2018.

HHS created the Health Care Payment Learning and Action Network (“Network”) to help increase the incentives to make changes and reduce the obstacles to implementation. A successful adoption of a value-based system and alternative payment models requires buy-in from payers.

A kickoff event for the Network was held on March 25, 2015 and included remarks from President Obama.

Public and private payers, purchasers, providers, consumers, and states can participate in the Network. Interested parties can register online and access a list of all organizations that have set a goal toward payment reform. According to the Centers for Medicare and Medicaid Services (CMS), more than 2,800 partners have already registered.

The MITRE Corporation, an independent contractor, was selected to manage the Network and will be funded by CMS. The use of an outside party for Network management ensures an unbiased support system.

What Services Will the Network Offer?

The Network will act as both a convener of meetings, webinars, and other live and virtual events and as a facilitator to provide support for committees and workgroups. It will also create best practices white papers available to both registered participants and the public.
Specific objectives of the Network are to:

  • 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.

PAMED Offers Innovative Value-Based Care Education for Pennsylvania Physicians
The Pennsylvania Medical Society (PAMED), with the help of physician experts, has developed its own educational series to address your questions on the transition to volume to value and what it means for practitioners in the state.

Registration for the innovative CME series which includes both online courses and live sessions is available now. Learn more about how members can save with package deals and register here.

Additional PAMED Resources:

    • Primary care medical home video—Find out how can this payment model make patient care more efficient.
    • The ACA – Five Years Later video—What have we learned since the Affordable Care Act (ACA) was signed into law on March 23, 2010?
    • Physician Leadership Education—Includes online courses and live sessions designed to help you drive change and face challenges.
    • Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VBPM) resources—Learn more about incentives and penalties.
    • Training on Shared Decision Making—Register now for a free one-day workshop in Harrisburg on May 21 and learn how to help patients make health care decisions.
    • Learn more about emerging payment models—Access PAMED’s online publication “Life after Fee-for-Service: A Physician’s Guide to Success in Emerging Budget-Based Payment Options.”