Ambitious National Effort to Adopt Alternative Reimbursement Models
Patricia Simino Boyce
(Lake Success, NY) August 24, 2016 –– IPRO has received special recognition from the Health Care Payment Learning & Action Network (LAN), a national public-private partnership aimed at adopting alternative payment models (APMs) that reduce costs and improve outcomes for patients. As a LAN “Committed Partner,” IPRO agrees to take concrete steps to promote reimbursement methodologies that reward value and incentivize improvement. The LAN’s goals include a target of linking 30% of all health care payments in the U.S. to quality and value via APMs by the end of 2016, and linking 50% of all such payments to APMs by 2018. APMs offer providers and practitioners financial risks and rewards based on meeting specific performance benchmarks.
“We’re delighted to be partnering with the LAN in its effort to reward and incentivize providers who demonstrate value in the clinical services they provide,” according to IPRO Chief Executive Officer Theodore O. Will. “It’s critically important that we develop a consensus on the measurement tools and supports necessary to encourage efficient, patient-centered care, rather than continuing to rely on a system that reimburses providers largely on the basis of how many itemized services they provide.”
With the final release of recommendations on Clinical Episode Payment and Population-Based Payment Models, the LAN pivots focus to its next phase of work: assembling multi-stakeholder action collaboratives to share their experiences implementing these recommendations, The LAN is also engaged in a National Measurement Effort that systematizes data collection in order to document progress in reaching the APM payment goals and has established a Primary Care Payment Model Work Group to accelerate implementation at the physician practice level. A LAN Committed Partner is an organization that has committed to specific targets that match or exceed the established goals for accelerating APM adoption. A partner also agrees to work with the LAN and to measure and report progress toward the goals it has set for transitioning to a system that advances quality of care over quantity of services. Guidelines for becoming a LAN Committed Partner are available at https://hcp-lan.org/step-up/.
A nationally recognized not-for-profit currently operating in 33 states and territories, IPRO offers a wide range of services including quality improvement and assessment activities; utilization review; independent review of patient appeals; data collection, analysis and validation; anti-fraud and abuse analytics and online performance reporting for government agencies, managed care organizations and private sector clients. In addition, IPRO operates the WhyNotTheBest website, a comprehensive quality improvement resource that analyzes the performance of 5,686 acute care hospitals in the U.S.
An ISO certified organization, IPRO is headquartered in Lake Success, NY, with offices in Albany NY, as well as Connecticut, New Jersey, Pennsylvania, North Carolina, Ohio and California. For more information about IPRO, please visit ipro.org.