Skip to main content
Subscribe
  • Login
  • My Account
  • Logout
  • Register For Free
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HLTH 2024
    • Sponsored Content: Vital Signs Blog
  • Opinion
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • 40 Under 40
    • Best Places to Work in Healthcare
    • Healthcare Marketing Impact Awards
    • Innovators Awards
    • Diversity Leaders
    • Leading Women
    • Best in Business Awards
    • The 2030 Playbook Conference
    • Innovations in Patient Experience
    • Leading Women Conference & Awards Luncheon
    • Leadership Summit
    • Workforce Summit
    • Best Places to Work Awards Gala
    • Diversity Leaders Gala
    • - Looking Ahead to 2025
    • - Financial Growth
    • - Hospital of the Future
    • - Value Based Care
    • - Looking Ahead to 2026
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Skilled Nursing Facilities
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
    • Sponsored Content
MENU
Breadcrumb
  1. Home
  2. Opinion
April 28, 2017 12:00 AM

Guest commentary: Collaboration driving progress in the shift to APMs

Dr. Sam Nussbaum, Dr. Mark D. Smith and Dr. Mark McClellan
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    In the largest and most comprehensive initiative of its kind, the public-private Health Care Payment Learning & Action Network (LAN) last fall announced results from a nationwide effort measuring adoption of alternative payment models (APMs) by both commercial and public health plans. The findings estimated that nearly a quarter of payments would be in APMs in 2016, including 41% for Medicare Advantage and 22% for commercial payments. Importantly, this historic effort paves the way for future APM measurement—including an upcoming 2017 LAN initiative—as health plans address rising costs by shifting to smarter spending with better health outcomes.

    For the first time ever, the 2016 measurement effort brought together public and private payers to improve our collective understanding of the state of payment innovation. The LAN's survey instrument queried commercial, Medicare Advantage, Medicaid managed-care plans, and fee-for-service Medicaid states. Survey questions and metrics tracked the categories of the LAN's APM Framework, measuring health plan spending through APMs. This collaboration was a major step forward for aligning government and private payers, and illustrates what we can accomplish when diverse stakeholders work together toward a shared vision.

    The LAN's 2016 report shows growing alignment among paayers as they move into value-based payment models. When comparing 2015 and 2016 figures, we see a shift toward Categories 3 and 4 of the APM Framework. These results point to progress toward payment models in which providers can focus on delivering efficient, high-quality care for all patients. Additionally, the results show Medicare is not operating in isolation in the move to value in healthcare. Instead, we see the movement to smarter spending being achieved through collaboration amongst all payers.

    Rising costs, missed opportunities to improve care, and a growing understanding that the fee-for-service model may impede coordinated care make the shift to smarter spending increasingly urgent. The question is not whether we need to shift, but how quickly it can be accomplished. The survey shows important progress in the use of APMs. The prevalence of payment reforms highlights the need for emphasis on tackling operational issues in care delivery and sharing effective strategies to accelerate the transition to better outcomes for patients and families. Further measurement efforts can help characterize how much of the APM payments are linked to quality and value, and which forms of APMs are having the greatest impact. By participating in the LAN's measurement efforts, payers can work toward harmonization of payment approaches and prepare for the future by viewing their payments through an APM lens.

    The LAN is gearing up for its second nationwide APM measurement effort, again measuring APM adoption among payers. By developing a common nomenclature for APMs—and promoting broad collective understanding of effective approaches—the framework has established a path that others can follow to accelerate reforms.

    The LAN aims to accelerate the adoption of effective payment reforms through shifting more healthcare spending into APMs. The 2017 measurement effort will be an important contribution to continued momentum. Vital to achieving our goal, we are seeking input from those at the front lines about challenges in APM adoption and how we can collaborate on solutions. We thank all those who participated in the 2016 survey, and urge all to join our upcoming efforts and encourage your payer partners to support this common vision with action on the ground.

    Dr. Sam Nussbaum is a senior fellow at the University of Southern California Schaeffer Center for Health Policy and Economics; Dr. Mark D. Smith is a visiting professor, University of California at Berkeley, and clinical professor of medicine, University of California at San Francisco; and Dr. Mark McClellan is director of the Robert J Margolis Center for Health Policy and the Margolis Professor of Business, Medicine and Health Policy at Duke University.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Tenet-Leapfrog
    Leapfrog Group sends cease-and-desist letter to Tenet hospitals
    UnitedHealth-group-screen-0425
    UnitedHealth Group to cut Medicare drug plan commissions
    Most Popular
    1
    'Legendary' Hemsley takes over at UnitedHealth amid rough seas
    2
    Big retail tried to disrupt healthcare—who is making a dent?
    3
    These are the regulations the AHA wants RFK Jr. to scrap
    4
    Downside risk, upside payment highlight new CMS innovation agenda
    5
    Medicaid cuts bill clears key House committee
    Sponsored Content
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2025. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HLTH 2024
      • Sponsored Content: Vital Signs Blog
    • Opinion
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • 40 Under 40
        • Best Places to Work in Healthcare
        • Healthcare Marketing Impact Awards
        • Innovators Awards
        • Diversity Leaders
        • Leading Women
        • Best in Business Awards
      • Conferences
        • The 2030 Playbook Conference
        • Innovations in Patient Experience
        • Leading Women Conference & Awards Luncheon
        • Leadership Summit
        • Workforce Summit
      • Galas
        • Best Places to Work Awards Gala
        • Diversity Leaders Gala
      • Virtual Briefings
        • - Looking Ahead to 2025
        • - Financial Growth
        • - Hospital of the Future
        • - Value Based Care
        • - Looking Ahead to 2026
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Skilled Nursing Facilities
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing
      • Sponsored Content