Alternative Payment Model (APM) Framework

The Health Care Payment Learning & Action Network (LAN) was created to drive alignment in payment approaches across the public and private sectors of the U.S. health care system. The CMS Alliance to Modernize Healthcare (CAMH), the federally funded research and development center operated by the MITRE Corporation, was asked to convene this initiative.

To advance this goal, the Alternative Payment Models Framework and Progress Tracking Work Group (“the Work Group”) was charged with creating an alternative payment model (APM) Framework (“the APM Framework”) that could be used to track progress towards payment reform. In order to accelerate the transformations described above, CAMH’s Guiding Committee charged the Work Group with creating an APM Framework through which progress towards payment reform can be described and measured. In addition to providing a roadmap to measure progress, the APM Framework helps establish a common lexicon and a shared set of conventions to facilitate discussions among stakeholders and quickly generate evidence-based knowledge about the capabilities and results of APMs.

The Work Group, composed of diverse health care stakeholders, has deliberated and reached consensus on critical issues related to the classification of APMs, resulting in a rationale and a pathway for payment reform that is capable of supporting the delivery of person-centered care. This is described in a white paper (PDF - 629.06 KB), which provides useful information to those working on the financing and sustainability of integrated behavioral health in medical care strategies.

A graphic of the framework (PDF - 108.05 KB)

Access a webinar on the APM white paper

Background on the LAN

Posted March 2016