Network kickoff highlights nationwide payment reform

President Obama, HHS Secretary Sylvia Burwell, and a host of other health care payers, providers, state representatives, and patient advocates launched the Health Care Payment Learning and Action Network (HCPLAN) on March 25, 2015, HHS announced. HCPLAN is an effort to spread the achievements and lesson s learned from the first five years of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) to lower costs and improve quality by using alternative payment models, which tie payment to value and health outcomes rather than the volume of services delivered.

Short-term goals

Secretary Burwell has set a goal for 30 percent of all Medicare payments to be based on alternative payment models by 2016 and 50 percent by 2018. At the kickoff gathering, she urged private sector payers to match or beat the Medicare goals.

ACA implementation

The ACA introduced several payment reforms that have already been effective at saving both lives and money, according to HHS. The efforts to reduce hospital-acquired conditions (HACs) and to prevent readmissions within 30 days of discharge from the hospital both have generated significant results. Between 2010 and 2013, HACs dropped 17 percent, resulting in 50,000 fewer patient deaths and avoiding $12 billion in health care costs. Similarly, the readmission rate dropped by about 8 percent in 2012 and 2013, resulting in 150,000 fewer readmissions. According to HHS, the accountable care organization programs have saved $417 million in Medicare spending.

Network activities

An HCPLAN contractor will serve as a “convener,” bringing network participants together in working groups, webinars, and large meetings to discuss best practices and whether variations among payment models can be harmonized. The HCPLAN also will provide support to a guiding committee and work groups, which will propose priorities and write summary papers.

Participants

As of the date of launch, more than 2,800 organizations and individuals have registered to participate in HCPLAN. MITRE has been chosen as the contractor for the Network. Active participants include the American College of Physicians, the American Cancer Society, Caesars Entertainment, Cigna, the State of Delaware, Dignity Health, and RiteAid. Caesars is testing a bundled payment model for hip and knee replacements, which will base payment on outcomes and could dramatically reduce patients’ cost sharing.

All participants are expected to subscribe to the goals and to work on a project to fulfil them. Most meetings will be held via webinar or teleconference. Additional information about the operation of the HCPLAN is available at http://innovation.cms.gov/initiatives/Health-Care-Payment-Learning-and-Action-Network/.