APM MEASUREMENT EFFORTCommercial health plans, Managed Care Organizations (MCOs), state Medicaid agencies, Medicare Advantage (MA) plans, and Medicare voluntarily participated in a national effort to measure the use of Alternative Payment Models (APMs) as well as progress towards the LAN's goal of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018.

30%50%

20182016

In 2018,35.8% of U.S. health care payments, representing approximately 226.5 millionAmericans and 77% of the covered population, flowed through Categories 3&4 models.

In each market, Categories 3&4 payments accounted for:

COMMERCIAL MEDICAREADVANTAGE

TRADITIONALMEDICARE

MEDICAID

Representativeness of covered lives: Commercial - 61%; Medicare Advantage - 67%; Traditional Medicare - 100%; Medicaid - 51%

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What Do Payers Think about the Future of APM Adoption?PAYERS’ PERSPECTIVE

not sure or didn’t answer

2%?think APM activity

will increase

Categories Payers Feel Will Increase the Most

91%think APM activity will stay the same

7%think APM activity

will decrease

0%

3B 3A

Strongly Agree/Agree

Strongly Disagree/Disagree

Will APM adoption result in...?

...better quality of care?

...more affordable care?

...improved care coordination?

...more consolidation among health care providers?

...higher unit prices for discrete services?

97% 2%88% 4%95% 2%56% 19%

9% 63%

Unsure

1%8%3%

25%

28%

45% 31% Top 3 Barriers:1. Provider willingness to take on financial risk2. Provider ability to operationalize3. Provider interest/readiness

Top 3 Facilitators:1. Health plan interest/readiness2. Government influence3. Provider interest/readiness

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COMMERCIALCommercial health plans, Managed Care Organizations (MCOs), state Medicaid agencies, Medicare Advantage (MA) plans,

and Medicare voluntarily participated in a national effort to measure the use of Alternative Payment Models (APMs) as well as progress towards the LAN's goal of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018.

/Payment-Network Search: HCPLANWWW.HCP-LAN.ORG PaymentNetwork@mitre.org @Payment_Network

MEDICARE ADVANTAGECommercial health plans, Managed Care Organizations (MCOs), state Medicaid agencies, Medicare Advantage (MA) plans,

and Medicare voluntarily participated in a national effort to measure the use of Alternative Payment Models (APMs) as well as progress towards the LAN's goal of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018.

/Payment-Network Search: HCPLANWWW.HCP-LAN.ORG PaymentNetwork@mitre.org @Payment_Network

TRADITIONAL MEDICARECommercial health plans, Managed Care Organizations (MCOs), state Medicaid agencies, Medicare Advantage (MA) plans,

and Medicare voluntarily participated in a national effort to measure the use of Alternative Payment Models (APMs) as well as progress towards the LAN's goal of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018.

/Payment-Network Search: HCPLANWWW.HCP-LAN.ORG PaymentNetwork@mitre.org @Payment_Network

MEDICAIDCommercial health plans, Managed Care Organizations (MCOs), state Medicaid agencies, Medicare Advantage (MA) plans,

and Medicare voluntarily participated in a national effort to measure the use of Alternative Payment Models (APMs) as well as progress towards the LAN's goal of tying 30% of U.S. health care payments to APMs by 2016 and 50% by 2018.

/Payment-Network Search: HCPLANWWW.HCP-LAN.ORG PaymentNetwork@mitre.org @Payment_Network