307– Alternative Payment Model Initiative Strategies and – Performance-Based Payments Incentive Effective Date: 10/01/17 Purpose This Alternative Payment Model (APM) Initiative - Strategies and Performance-Based Payments Incentive Policy applies to Acute Care, Arizona Long Term Care System Elderly and Regional Physical Disability (ALTCS/EPD), Children’s Rehabilitative Services (CRS), Behavioral Health Authority (RBHA), ALTCS Division of Economic Security/Developmental Disabilities (DDD) Contractors and DDD Sub-Contractors. The purpose of this initiative is to encourage Contractor activity in the area of quality improvement, particularly those initiatives that are conducive to improved health outcomes and cost savings, by aligning the incentives of the Contractor and provider through APM strategies. Definitions A model which aligns payments between payers and providers Alternative Payment Model Strategies to incentivize quality, health outcomes and value over volume (in LAN-APM to achieve the goals of better care, smarter spending and healthier people. Category Order) The APM strategies discussed in this initiative originate from the Learning Action Network APM Framework (LAN-APM) which include the following categories and strategies: Fee-For-Service No Link To Quality & Value, – Fee-For-Service Link To Quality & Value – (Foundational Payments for Infrastructure & Operations, Pay for Reporting, Pay for Performance), APMs Built on Fee-For-Service Architecture (APMs with Shared Savings, APMs with Shared Savings and Downside Risk), Population Based Payment (Condition-Specific Population-Based Payment, Comprehensive Based Payment, Integrated Finance & Delivery Systems). See Attachment A to view the LAN-APM strategies. Fee-For-Service No Link To Quality & Value (LAN-APM Category 1) –
307– Alternative Payment Model Initiative – Strategies and Performance-Based Payments Incentive Effective Date: 10/01/17 Purpose This Alternative Payment Model (APM) Initiative - Strategies and Performance-Based Payments Incentive Policy applies to Acute Care, Arizona Long Term Care System Elderly and Physical Disability (ALTCS/EPD), Children’s Rehabilitative Services (CRS), Regional Behavioral Health Authority (RBHA), ALTCS Division of Economic Security/Developmental Disabilities (DDD) Contractors and DDD Sub-Contractors. The purpose of this initiative is to encourage Contractor activity in the area of quality improvement, particularly those initiatives that are conducive to improved health outcomes and cost savings, by aligning the incentives of the Contractor and provider through APM strategies. Definitions Alternative Payment Model Strategies (in LAN-APM Category Order) A model which aligns payments between payers and providers to incentivize quality, health outcomes and value over volume to achieve the goals of better care, smarter spending and healthier people. The APM strategies discussed in this initiative originate from the Learning Action Network APM Framework (LAN-APM) which include the following categories and strategies: Fee-For-Service – No Link To Quality & Value, Fee-For-Service – Link To Quality & Value (Foundational Payments for Infrastructure & Operations, Pay for Reporting, Pay for Performance), APMs Built on Fee-For-Service Architecture (APMs with Shared Savings, APMs with Shared Savings and Downside Risk), Population Based Payment (Condition-Specific Population-Based Payment, Comprehensive Payment, Integrated Finance & Delivery Systems). See Attachment A to view the LAN-APM strategies. Fee-For-Service – No Link To Quality & Value (LAN-APM Category 1) Based
307-Alt_Pay_Model_Init-Strategies_and_Perf_Based_Payments_Incentive.docx