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Building alternative payment models in health care.

Steven W Howard1, Natalie Bradford2, Rhonda Belue2

  • 1Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States.

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Summary

Industry experts shared insights on designing and implementing alternative payment models (APMs) for healthcare. Key findings highlight the crucial role of physician leadership and practice transformation, alongside regulatory concerns impacting APM success.

Keywords:
alternative payment modelcare coordination and care managementhealth care cost and utilizationhealth care innovationhealth care transformhealth outcomesquality improvementvalue based care

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Area of Science:

  • Health Services Research
  • Healthcare Management
  • Health Economics

Background:

  • Growing global interest in value-based healthcare models.
  • Evidence gaps exist regarding alternative payment models (APMs) in early stages and private contracts.
  • Need for understanding expert design and implementation of APMs.

Purpose of the Study:

  • To update literature on APM design and implementation by industry experts.
  • To identify key elements and stakeholders in APM development.
  • To explore how APMs are practically designed and contracted.

Main Methods:

  • Conducted a literature review to guide research.
  • Employed snowball sampling to recruit 16 subject matter experts (SMEs).
  • Performed 16 semi-structured interviews across the US, Netherlands, and Germany, analyzed thematically.

Main Results:

  • Identified five key design themes: population/scope, data/technology, finance/incentives, provider partnerships, and leadership/regulation.
  • Confirmed existing APM components and highlighted the importance of physician leadership and practice transformation.
  • Found significant regulatory barriers related to data sharing and price-setting that hinder APM experimentation and success.

Conclusions:

  • Physician leadership and practice transformation are critical for APM success.
  • Policymakers must address regulatory hurdles in data sharing and pricing for APMs to thrive.
  • Further research is needed to optimize APM design and implementation in diverse healthcare settings.