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Stakeholders who are working to develop Alternative Payment Models (APMs) are facing a number of significant barriers and challenges, and those who would implement APMs or receive care supported by them have expressed a number of serious concerns about the way APMs are currently being designed and about potential negative consequences poorly-constructed APMs may have on patients, providers, payers, and communities. Failing to address these problems in a proactive and effective way will slow progress in improving the quality and affordability of healthcare and make it difficult to build support for implementing more effective payment models.
To address these issues and formulate recommendations on how stakeholders might approach barriers in a collaborative way, more than 80 national and local health care leaders from 33 states convened in Washington D.C. in June for the 2016 National Payment Reform Summit. The Summit was convened by the Network for Regional Healthcare Improvement with assistance from the Center for Healthcare Quality and Payment Reform and with generous financial support from the Robert Wood Johnson Foundation. Together the group compiled the recommendations contained in this Summary Report. The group included physicians from 16 different specialties; executives of national and regional self-insured businesses; leaders of employer purchasing coalitions; representatives of hospital and medical associations; health plan executives; foundation leaders; directors of Regional Health Improvement Collaboratives; federal and state government officials; executives of health care Quality Improvement Organizations; consumers and representatives of labor organizations; and others with expertise and experience in efforts to design and implement better payment systems.
The recommendations are detailed in sections that reference eight key barriers and challenges to successful payment reform. We hope you will share this report with colleagues and other stakeholders and use it to continue conversations in your organization, community and region.