AHCA PRODUCT OF THE WEEK – POPULATION HEALTH MANAGEMENT (PHM) INNOVATION LAB

AHCA/NCAL launched the first phase of its Population Health Management (PHM) Innovation Lab last June. Unfortunately, that was the height of the pandemic and providers had little time to focus on anything but COVID. As a reminder, AHCA has a plethora of free “member only” resources in the Innovation Lab to help members succeed as population health and value-based models become more important as the nursing home and assisted living sectors recover from the COVID era.

One such PHM example is provider-led special needs plans whose clinical model includes the deployment of on-site nurse practitioners providing primary care at the long term care bedside thereby avoiding costly and potentially dangerous hospital transfers, even more critical during COVID. Further, value-based payment models will continue to be a focus of this Administration.

 Phase 1 PHM Innovation Lab Resources

The PHM Innovation Lab Phase I offers foundational resources on six different subject areas with corresponding educational components including webinars and briefs.

1. Population Health Management Fundamentals — Describes the who, what, where, and how of Population Health Management (PHM). It also introduces various PHM models including their specific characteristics, benefits, and implications. This module includes a 42-minute webinar and a two-page brief.
2. Accountable Care Organizations — Provides an overview of the structure, financial model, and regulatory requirements of different ACOs. Types of ACOs covered include Medicare Shared Savings Programs and Next Generation ACOs. This module contains a 41-minute webinar and three-page brief about Medicare ACOs.
3. Bundled Payments — Provides an overview of the basics of bundled payments (episode-based payments) including what are bundled payments, how do they work, and their implications for LTC and PAC providers. This module includes a 23-minute 101 webinar and three-page brief discussing different bundled payment models.
4. Emerging Models: Direct Contracting — Provides a detailed overview of Direct Contracting including types of participants, payment, beneficiary alignment, quality incentives, and a model timeline. This module contains four briefs and two webinars on Direct Contracting.
5. Managed Care — Provides an overview of Medicare Advantage/ Provider-led Special Needs Plans (SNPs) and explains how SNPs work, and discusses the implications for LTC and PAC providers. This module contains a 48-minute webinar and three briefs on various topics totaling 30 pages.
6. Provider Networks –Provides an overview of the why, what, and how of provider-owned integrated care networks and explains the benefits of provider networks. This module contains a 29-minute webinar and a one-page issue brief.

Members will need to login with their AHCA/NCAL usernames and passwords to access PHM Innovation Lab materials. For assistance obtaining AHCA/NCAL usernames and passwords, members should e-mail educate@ahca.org with their name and facility contact information.

About PHM Innovation Lab Phase II

Phase II of the PHM Innovation Lab will contain resources for purchase, including self-assessments, targeted in depth training for leadership and facilities, roadmaps for initial due diligence and strategic planning. AHCA/NCAL anticipates launching Phase II at the end of the year. AHCA/NCAL will provide state affiliates with additional information prior to the Phase II launch.