The technology and business processes in place 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.
As an organization whose essential mission is to provide global leadership for the optimal use of information technology and management systems for the betterment of healthcare, HIMSS is keenly aware that without the technology needed to support them, APMs are endanger of becoming the last great thing that couldn’t save the American healthcare system. We are cognizant of recent studies declaring administrative tasks the number one cause of burnout for physicians, and a 2011 paper indicated even before the introduction of APMs, for every physician in the U.S., there were 2.2 administrative workers.
These are the concerns that led to the creation of the HIMSS Alternative Payment Model Infrastructure 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. The task force has identified six structural areas of focus: Governance; Program Administration and Operations; Information Management; Finance/Revenue Cycle Management; Contracting, and Clinical Integration. The first three toolkits were recently introduced on the task force webpage. The remaining three will be introduced over the next several months. These 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.
APMs have the potential to transform the way healthcare is delivered in this country, and increase patients’ engagement in their health, but only if we ensure they have the right chassis to support them. Working together as a community, we can make sure that happens.
Peckham, Carol. “Medscape Lifestyle Report 2017: Race and Ethnicity, Bias and Burnout.” Medscape. January 11, 2017. http://www.medscape.com/features/slideshow/lifestyle/2017/overview#page=4
 Cutler DM, Ly DP. The (Paper)Work of Medicine: Understanding International Medical Costs. The journal of economic perspectives : a journal of the American Economic Association. 2011;25(2):3-25.
About the author: Pam has more than 25 years' healthcare industry experience. As the Senior Director of Health Business Solutions for HIMSS, she oversees the overall management and strategy development for HIMSS Health Business Solutions initiatives.