This report provides results of a study – the largest and most comprehensive of its kind – measuring use of Alternative Payment Methodologies (APMs) among public and private health plans that agreed to participate in the study. Conducted from May 19, 2016 to July 13, 2016, the findings capture actual health care spending from 2015 and provide an estimate of spending as of January 2016 across commercial, Medicare Advantage, and Medicaid market segments.
The report is designed to help leaders - including providers, payers, and employers - who are working, or wish to work, in alternative payment models (APMs) to understand what information they will need from outside their organization and the processes involved in obtaining that information. It is also an aid for third party entities, including vendors, policymakers and others that provide access to the data sources and data sharing processes that support APM efforts.
Stakeholders who are developing Alternative Payment Models (APMs) face a number of challenges, and those implementing or receiving care supported by APMs have concerns about APM design and potential negative consequences poorly-constructed APMs may have on patients, providers, payers and communities. Recommendations for addressing eight of these challenges were developed by the the 80 national health care leaders who participated in the 2016 National Payment Reform Summit.
Many physicians, hospitals, and other providers across the country find that the current fee–for–service payment system creates
barriers to implementing or sustaining better approaches to health care delivery. Consequently, payment reforms must be an integral part of
any strategy to create a higher–value health care system. This white paper describes the building blocks for successful payment reform and how communities might approach these building blocks to meet their unique circumstances.
This document features advice from leading Regional Health Improvement Collaboratives (RHICs), including ones in California, Ohio, Colorado, Maine, Minnesota, Oregon, and Missouri,that have been advancing their communities toward greater transparency of cost and quality information for years and overcoming barriers of all kinds.
This issue brief describes why the industry must move beyond common but insufficient methods of measuring cost of care, and toward total cost
of care, and what types of entities are well-positioned to lead this work. It presents five core components of measuring, analyzing, and reporting total
cost, and presents the challenges associated with this task.
Nasreen Abdullah, Robert S. Laing, Susan Hariri, Collette M. Young, & Sean Schafer published a study using Q Corp claims data on how to estimate the percentage of women in a geographic population that have had cervical cancer screening. Their nfindings introduces a novel method to estimate population-level cervical cancer screening. Overall, the percentage of women screened in Portland, Oregon fell following changes in screening recommendations released in 2009 and later modified in 2012.
This white paper offers guiding principles and recommendations that should be considered in data sharing arrangements in Population-Based Payment models. The paper outlines a series of “use cases” for data sharing that describe particular types of data sharing arrangements, in both their current and aspirational states. The goal is to create an environment where data follows the patient and is available to all stakeholders (patients, providers, purchasers, and payers) in a timely manner.
This toolkit is intended to support communities in creating equity atlas projects by providing an overview of the equity atlas development process along with sample materials and links to helpful resources. An equity atlas is a tool that enables us to understand how well different neighborhoods and populations are able to access the resources and opportunities necessary for meeting their basic needs and advancing their health and well-being.
"Aligning Health Measurement in Oregon" is a new whitepaper that was completed as a result of two years of research by CHITO to study and develop recommendations around proliferation of a overlapping - and sometimes competing - state, federal, and commercial health care quality reporting initiatives and mandates. The whitepaper provides a pared-down, simplified approach to health measurement in Oregon.
The National Health Care Payment Learning and Action Network Alternative Payment Models Framework and Progress Tracking Work Group was charged with creating an Alternative Payment Model (APM) Framework that could be used to track progress towards payment reform. Composed of diverse
health care stakeholders, the Work Group deliberated and reached consensus on many critical issues related to the classification of APMs, resulting in a rationale and a pathway for payment reform.
The American Medical Association and Center for Healthcare Quality and Payment Reform's Guide to Physician-focused Alternative Payment Models describes 7 ways of structuring APMs that can be used to address the most common opportunities and barriers that physicians face.
This toolkit showcases how primary care practices are involving patients in quality improvement efforts as part of Aligning Forces for Quality, including resources developed through Q Corp's Patients and Families as Leaders program.
On October 14, 2013 Q Corp, CareOregon, PeaceHealth Medical Group and Providence Medical Group co-hosted a daylong event highlighting patient engagement initiatives in Oregon. This document includes graphic recordings of the presentations and discussions at the event.