Launched in 2015 by the U.S. Department of Health and Human Services (HHS), the Health Care Payment Learning & Action Network (LAN) is a public-private partnership whose mission is to accelerate the health care system’s transition to alternative payment models (APMs) by aligning the innovation, power, and reach of the private and public sectors. The LAN’s purpose is to facilitate the shift from the fee-for-service (FFS) payment model to a model that pays providers for quality care, improved health, and lower costs. The LAN is led by a Guiding Committee that provides executive leadership and strategic direction to accelerate achieving the goals described below. The LAN offers stakeholders a broad portfolio of resources to facilitate that transition, including the APM Framework, primary care and maternity care APM resource banks, and white papers on a wide range of topics related to designing episode-based and population-based APMs.
The APM Framework is the LAN’s landmark contribution to health care payment transformation via APMs. It captures a continuum of clinical and financial risks for provider organizations across four payment categories.
At least nine states are using the Framework to track spending in Medicaid managed care contracts, and many require payers to meet spending targets in Categories 2 through 4.
Health care professionals include payers, purchasers, consumer and patient advocates, state agency and Medicaid representatives, federal agency representatives, and national policymakers
Created a Large Portfolio of Resources
- White papers and informational graphics
- Resources on population-based payment, clinical episode payment, data sharing, and primary care payment reform that stakeholders can use to facilitate APM adoption
Facilitated Two National Forums for Stakeholders to Develop Real-world Solutions to APM Design and Other Implementation Challenges
- The Primary Care Payer Action Collaborative (PAC) convened payers involved in multi-payer primary care APMs and created the Primary Care Payer Action Collaborative Resource Bank, full of useful sources to help payers operationalize alternatives to fee-for-service payment
- The Multi-Stakeholder Maternity Care Action Collaborative (MAC) convened stakeholders across the maternity care system to learn about proven strategies for designing and implementing episode payment models for maternity care. The MAC led to the development of the Maternity Episode Payment Online Resource Bank, a one-stop-shop for maternity APMs, including information on making the business case for maternity APMs and lessons learned.