Health Care Payment Learning & Action Network (LAN) Summit 2019

On October 24, 2019, I had the pleasure of attending the LAN Summit in Washington, DC. The Health Care Payment Learning & Action Network (LAN) was created in 2015 by the U.S. Department of Health and Human Services (HHS). It’s a public-private partnership with a mission “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.”[1]

Three major themes were presented this year at the LAN Summit:

  • APM Design
  • Payer-Provider Collaboration
  • Person-Centered Care

All three themes are very relevant in today’s healthcare environment since they touch on all the stakeholders being involved and working together.

The opening plenary featured a real-world view of the transformation of health care, highlighting perspectives from across the industry – payers, providers, patients, purchasers, product manufacturers, and policymakers. Bruce Broussard, CEO of Humana, Dr. Christopher Chen, CEO of ChenMed, Dr. Susan Frampton, President of Planetree International, Adam Stavisky, Senior Vice President, US Benefits of Walmart, and Nick Leschly, CEO of Bluebird Bio each presented on how the various stakeholders can partner to fill these gaps and propel value-based payment models. Specifically, all speakers highlighted the need for more transparency in patient-facing quality measures. Mr. Stavisky highlighted that Walmart has already rolled out a specialist scorecard that highlights high-value providers as “green.” Dr. Frampton told a personal story about trying to locate a primary care provider for her mother in Florida, and having difficulty finding quality information to inform the decision, which resulted in her reading Yelp reviews. She had an astute observation that consumers resort to TripAdvisor, and other sites, to obtain quality information on hotels, restaurants, and other services; so why is there no easily digestible quality information on physician services? A public forum to discuss your physician does not allow for a physician to write back or even acknowledge the post and can be sued immediately for violation of HIPAA therefore, a public rating such as Yelp[2] is not the answer but maybe there is another one?

For the first breakout session of the conference, I attended “Data Sharing and Interoperability: Payer-Provider Data Exchange in Successful Shared Accountability Models,” which featured payers, providers, and CMS speaking to the technical issues in developing interoperable data exchange infrastructure. The discussion highlighted Medicare’s Blue Button Portfolio: Blue Button (for Medicare beneficiaries, single data cell), Beneficiary claims data (For ACOs, bulk data calls), and data at the point of care (for providers, bulk data calls). For those that are unfamiliar with CMS’ Blue Button 2.0, it was first announced at the HIMSS 2018 conference in March of that year. It’s an Application Programming Interface (API) that contains four years of Medicare Parts A, B and D data for 53 million Medicare beneficiaries. While Shafiq Rab (Rush University System for Health) encouraged all organizations in the room to take advantage of the availability of this data because there was toolkits available online, I’m not sure how realistic, easy, and/or cost effective it would be for most provider organizations to interface with Blue Button 2.0 in its current state. However, large organizations with significant financial resources to invest in application building and ability to focus on security such as Humana, eClinicalWorks, Verily and Rush University Medical Center, have production applications.[3]

 For the second breakout session, I attended “Multi-Payer Alignment: Promising Practices for Developing Multi-Payer Models,” which highlighted the need to reduce provider burden in APM participation by aligning certain core elements of care delivery and operations across multiple payers. One of the biggest challenges that was highlighted during the session was the ability to get data from multi-payers in a similar format. It’s imperative to create a platform that pulls in data from multiple payers in one solution for apples-to-apples comparison and single or simplistic sign on for users.

For the third breakout session, I attended “Payer-Provider Collaboration to Improve Outcomes for High Need Populations.” High-need populations are most at risk for poor health outcomes due to lack of care coordination and care management. The speakers highlighted strategies such as the use of claims data to identify patients with multiple chronic conditions and/or patients with co-existing physical and behavioral health needs. It was explained that was then assigned to a care transformation team for ongoing management through innovative care management programs with behavioral health components.

This was my first LAN Summit, and I was impressed with the quality of the content and networking that was packed into just one single day. I hope to become more involved with the organization henceforth, and I look forward to attending next year’s conference!




Maria Nikol

About the Author

Senior Business Consultant

Maria Nikol is a Senior Business Consultant with over 12 years of experience in healthcare operations and strategy. She is passionate about the application of emerging policies within the value-based care space. Within her multifaceted position at Salient, she has taken a lead in developing business partnerships. She holds a Master of Jurisprudence in Health Law from Widener University and a Bachelor of Science in Pharmaceutical Marketing and Management from the University of the Sciences in Philadelphia. Her hope is to empower providers with the proper tools and knowledge to efficiently take better care of patients in this ever-evolving industry.

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