Developing an Advanced Alternative Payment Model for Stress Urinary Incontinence.

Area of Science:

• Healthcare policy
• Urogynecology
• Health economics

Background:

• The traditional fee-for-service model in healthcare leads to high costs and fragmented patient care.
• The Center for Medicare & Medicaid Services is transitioning to value-based care, incentivizing cost-effectiveness and coordinated services.
• Legislation like the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015 replaced fee-for-service with systems like the Merit-based Incentive Payment System and advanced Alternative Payment Models (aAPMs).

Purpose of the Study:

• To describe the development of an advanced Alternative Payment Model (aAPM) framework specifically for stress urinary incontinence.
• To detail the data selection and data plan integral to the aAPM framework.
• To discuss the challenges encountered during the creation of this aAPM.

Main Methods:

• Development of an advanced Alternative Payment Model (aAPM) framework.
• Selection of relevant data points for the aAPM.
• Creation of a comprehensive data plan for the aAPM.

Main Results:

• A framework for an advanced Alternative Payment Model (aAPM) for stress urinary incontinence has been conceptualized.
• Specific data elements and a data plan have been identified for implementation.
• Key challenges in aAPM development have been considered and addressed.

Conclusions:

• The proposed aAPM framework offers a pathway to value-based care for stress urinary incontinence.
• Successful implementation requires careful data management and consideration of development challenges.
• This initiative aligns with broader healthcare reform efforts to enhance quality and cost-efficiency.