The technology and business processes we use to support healthcare administrative functions today were designed to support our historical fee-for-service delivery model. They did not contemplate the level of information sharing, data analytics and quality reporting inherent in today’s emerging APMs; they cannot be easily tweaked to accommodate these new demands. The rate of APM adoption has quickly outpaced our ability to develop the technical solutions and business processes to support them. Those organizations who are participating in one or more APMs and who have deep enough pockets to do so are developing internal solutions; those with fewer resources or less sophisticated operations find themselves awash in manual work-arounds that lead to decreased efficiency and increased administrative costs.
These are the concerns that led to the creation of the HIMSS Alternative Payment Model Infrastructure (APMI) task force in July 2016. The purpose of the HIMSS APMI task force is to provide guidance on the administrative infrastructure necessary to support APMs. It has been a busy first year for the task force. Over the last several months, we have identified six structural areas of focus: Governance; Program Administration and Operations; Information Management; Finance/Revenue Cycle Management; Contracting, and Clinical Integration. We launched a HIMSS Alternative Payment Models Infrastructure website, created three of six toolkits intended to provide tools and resources to support the identified areas of focus, coordinated the delivery of a HIMSS17 full-day pre-conference symposium, and facilitated a webinar about how to create a community of care among disparate providers. The toolkits are living resources that will be added to over time, and will include links to resources created by members of the task force and other content areas within HIMSS, as well as outside resources, such as those produced by CAPG, America’s Health Information Management Association (AHIMA) or the Accountable Care Learning Collaborative (ACLC). We invite you to visit the webpage, check out the checklists and resources provided there, and let us know what you think. If you have content you would like to contribute, we would love to hear from you. Simply reach out to Pam Jodock at pjodock@HIMSS.org to schedule a call to discuss.
The stakeholders that make up this task force include representatives from healthcare payers, providers, and vendors, and association professionals with direct cost accounting, provider-payer contracting, quality reporting and revenue cycle management experience. In 2018, the task force will introduce the remaining three toolkits, produce four webinars, including a 3-part series on bundled payment infrastructure and a 1-webinar event on information integration, support delivery of our second annual emerging payment model pre-conference symposium, and publish a white paper detailing the reason behind and work of the APMI task force.
It has been my honor to serve as the inaugural Chair of this group. I am proud of the work we are doing, impressed by the expertise of our participants, and energized by the passion and commitment they bring. I look forward to continuing our mission and celebrating the impact of our work.
About the author: Jeff is the Senior Vice President of Revenue Cycle Management and President of Revworks at Cerner Corporation, and serves as Chair of the HIMSS Alternative Payment Model Infrastructure task force.