11/30/2016 | RESOURCES

Health IT Framework to support Alternative Payment Models

The Health IT Framework to support APMs (Framework) overlays both the current health IT infrastructure (top of the figure) and the ideal state health IT infrastructure (bottom of the figure) with the APM framework developed by the Health Care Payment Learning and Action Network (HCP-LAN).

The Framework demonstrates the progress that must be made as we move from traditional fee-for-service (FFS) payment models to population-based APMs, as well as the progress that has already been made by organizations currently participating in APMs. The Framework also shows that the ideal health IT to support FFS and FFS with quality and value linkage payment models, are the current state for APMs, meaning many APMs have already implemented these functions.

For ease of understanding, the functions and services in the Framework have been broken into six categories:
1) EHR System;
2) Care Coordination/Management;
3) Quality Measurement;
4) Data Aggregation and Attribution;
5) Risk Scoring;
6) Financial Management.


Providers may have multiple systems providing capabilities for each category, or they may use a platform that provides the functions of all five categories. Increasingly, vendors are building platforms that incorporate multiple categories of functions, rather than focusing on a single function, such as quality measurement.