1. What have we learned?

2. Competing demands Hard to keep all the balls in the air
APM implementation, refinement, spread
Bridging towards value-based pay
Practice transformation
Clinics face many demands
Expand access for 2014 patients
Hold down total cost of care
Improve quality & produce data – CCO, meaningful use, ICD-10, PCPCH, APCP…

3. Payment Model Lessons Model should be hand in hand with payment
Data/Outcomes should be clear, thoughtful, aligned
This is a Partnership requiring constant refinement and trouble shooting:
With Medicaid
Between clinics
IT and managed care
Financial stability as a requirement to participate (NOT a consequence)
Cascade of other financial implications:
Budgeting
Panel Size
Provider Reimbursement

4. Advanced Care Model: Lessons Learned
Never separate from payment
Consider immensity of change
Create less time pressure
Plan for data collection
Add ACM teams at all participating sites
Co-create OPCA-ACM teams
Keep learning (co-design is messy)

5. Early Outcomes Year 1
Year one report from OPCA and state contractor under production
Model appears budget neutral per patient, per year
APM reconciliations have not triggered payment to date.
MCO payments appear level
Clinical quality indicators appear to be holding or improving in most cases
Signs of improvement in total health care utilization
Access under ACA poses a challenge to transformation