What is HCPLAN?

A network connector and idea aggregator, the Health Care Payment Learning and Action Network (HCPLAN) advances payment approach alignment across the private and public sectors of the health system

The network accomplishes its goals through an online payment reform community known as “Handshake,” in-person meetings, work groups, and white paper publication.

In 2015, the Department of Health and Human Services (HHS) set a goal of tying 30 percent of Medicare fee-for-service payments to quality or value through alternative payment models (APM) by 2016 and 50 percent by 2018. HHS has also set a goal of tying 85 percent of all Medicare fee-for-service to quality or value by 2016 and 90 percent by 2018. As a part of this broader effort, HHS and stakeholders launched the Health Care Payment Learning and Action Network to advance alternative payment alignment across the private and public sectors of the health system. HCPLAN currently functions as a network connector and idea aggregator. The network accomplishes its goals through an online payment reform community called “Handshake,” in-person meetings, work groups, and white paper publication.

HCPLAN work groups are short-term groups charged with identifying and assessing the following: the main adoption barriers to alternative payment models; which of the main adoption barriers to alternative payment models can be addressed; creating a succinct outline of steps necessary to reach HHS’ goals; and motivating action toward sustainable APM development. Three work groups have been established: the Alternative Payment Model Framework and Progress Tracking Work Group; the Population Based Payment Work Group; and the Clinical Episode Payment Work Group.  While no surgical specialties are represented within the HCPLAN network or work groups, the Academy is closely monitoring the work group activities to review and comment on any proposals that would affect otolaryngologists.

APM Framework White Paper

The first tangible cooperative effort created by the HCPLAN governing body is the Alternative Payment Models Framework White Paper drafted by the APM Framework and Progress Tracking Work Group.

In October 2015, HCPLAN released their draft APM Framework White Paper for comments. After taking into account the comments provided by the Academy and other stakeholders, HCPLAN released the final version of the white paper in January. The APM Framework White Paper outlines a proposed working definition for alternative payment models and provides a rough trajectory for organizations wishing to transition from fee-for-service payments to a complete alternative payment model.

The Academy submitted comments on the draft APM Framework White Paper that reiterate our position that any alternative payment model framework must address the unique payment reform challenges faced by specialty physicians. Although surgical specialties are not currently represented in the established work groups and the APM Framework White Paper, the Academy is advocating on your behalf. We continue to work closely with our partners to ensure that any accepted APM framework will allow the largest possible numbers of physicians to not merely participate, but thrive within the framework’s constraints.

For more information on the future of payment and how payment reform could affect you, please visit the Academy’s payment reform information hub: www.entnet.org/content/payment-reform.