This meeting by the NAM’s Leadership Consortium Value Incentives & Systems Action Collaborative focused on the operational pre-requisites for outcome-based payment in health and health care. The meeting sought to answer the following questions:
- What are the defining features of outcome-based performance measurement systems that could drive real progress in health care quality, outcomes, and affordability? How can we move beyond rigid measure sets to more dynamic, clinically relevant approaches that better reflect what matters to patients and care teams?
- What technical, regulatory, and operational barriers are impeding the development and deployment of clinically sourced, low-burden outcome measures?
- What promising innovations, policy shifts, or alignment agreements are helping to advance outcome-based performance measurement? How can the National Academy of Medicine (NAM), its partners, and other key stakeholders accelerate progress?
Outcomes from this meeting seek to identify and describe requirements and standards for outcome-based payment; acknowledge and explore important transitions in quality reporting; discuss potential applications for artificial intelligence; and illuminate a path forward for securing alignment agreements, technological infrastructure, and governance for outcome-based payment.
Agenda
9:00 am: Welcome, Introductions, and Meeting Overview
- Remarks:
- Michael McGinnis, National Academy of Medicine
- Dana Gelb Safran, National Quality Forum
- Aneesh Chopra, Arcadia
- Presentation: Leadership Consortium Overview
9:30 am: Stakeholder Perspectives: What We Measure, What We Miss, and Why It Matters
Performance measurement is central to a Learning Health System and value-based care models aiming to improve outcomes, patient experiences, and affordability. Yet few believe it’s meeting that potential. Panelists will highlight barriers to and facilitators of effective measurement from different stakeholder perspectives, followed by a group discussion to align on the most important challenges and enablers.
- Moderator: Dana Gelb Safran, National Quality Forum
- Perspectives:
- Mark Friedberg, Blue Shield of Massachusetts (payer)
- Don Moulds, CalPERS (purchaser)
- Susannah Bernheim, CMMI (government)
- Ali Khan, Aetna/formerly Oak Street Heath (care delivery organization)
10:40 am: Morning Break
10:50 am: Infrastructural Requirements for Outcomes Reporting
Administrative burden remains a major obstacle in the shift from claims-based to clinical data reporting despite broad stakeholder support. This session will explore how data infrastructure and standards can be optimized to enable low-burden reporting, using Accountable Care Organizations as a use case.
- Moderator: Aneesh Chopra, Arcadia
- Perspectives:
- Travis Broome, Aledade
- Jess Walradt, Northwestern Medicine
- Megan Reyna, Bon Secours Mercy Health
12:00 pm: Networking Lunch
12:40 pm: The AI Advantage: Exploring the Potential for AI to Support Outcome-based Payment
This session will examine how AI can address challenges that have, thus far, prevented a shift toward clinically sourced outcome measurement in support of value-based payment and population health. Applications include the use of natural language processing to extract relevant outcomes and care activities from unstructured clinical notes and use of AI to translate, map, and harmonize data across FHIR, QRDA, and legacy formats to integrate clinical and claims data needed for comprehensive outcome measurement.
- Moderator: Aneesh Chopra, Arcadia
- Perspectives:
- Karandeep Singh, UC San Diego Health
- Celena Wheeler, Oracle
- Josh Mandel, Microsoft Health
1:50 pm: A Path Forward: Securing the Infrastructure and Processes Needed for Success
In this session, participants will identify actionable steps to advance high-value, low-burden, outcome-focused measures for value-based payment and population health. The discussion will address prospective alignment on measures developed and deployed, technological
infrastructure for outcome reporting, and governance processes to drive coordination and progress. The session will conclude with participant guidance on accelerative activities that can be undertaken by the NAM.
- Moderator: Dana Gelb Safran, National Quality Forum
- Perspectives:
- Monica Soni, Covered California
- David Blumenthal, Harvard University
- Marc Overhage, Indiana Health Information Exchange
3:20 pm: Closing Comments and Next Steps
- Aneesh Chopra, Arcadia
- Dana Gelb Safran, National Quality Forum
- Michael McGinnis, National Academy of Medicine
Questions? Email [email protected].
