On November 25, 2020, the U.S. Departments of Health & Human Services (HHS) and Treasury released the proposed 2022 “Notice of Benefit & Payment Parameters” (NBPP), the annual rule governing core provisions of the Affordable Care Act (ACA), including the operation of the marketplaces, standards for insurers, and the risk adjustment program. This expert perspective focuses on several provisions that have implications for state oversight of insurance markets and the state-based marketplaces. Comments on the proposed rule are due by December 30, 2020.
Categorizing Value-Based Payment Models According to the LAN Alternative Payment Model Framework: Examples of Payment Models by Category
Megan Burns and Michael Bailit, Bailit Health
As the movement from volume to value-based payment progresses, more state purchasers are requiring their contracted health plans to implement alternative payment models (APMs) with the goals of improving the quality of care and reducing costs for taxpayers. The Health Care Payment Learning and Action Network Alternative Payment Models Framework (the LAN APM Framework) is an increasingly common method being used by states to measure plan progress toward implementation of APMs. While the LAN offers purchasers a guidepost with which to categorize APMs, states still sometimes struggle with their interpretation of the LAN categories. This brief provides real-world examples of APMs within the LAN categories and can help states and other interested purchasers develop a common understanding of what types of payment models fit within the framework categories. The State Health Policy Highlight, Categorizing Value-Based Payment Models According to the LAN Alternative Payment Model Framework, provides a summary of each category for those interested in an overview of APM Framework.
On Wednesday, February 7, State Health and Value Strategies hosted a webinar based on the issue brief that featured real-world examples of what types of payment models fit within the LAN categories.