HCPLAN Survey Data Finds Progress on Alternative Payment Models
Health insurance plans are seeing continued growth in the adoption of value-based care arrangements and shared risk arrangements, according to the 2024 annual survey by the Health Care Payment Learning & Action Network (HCPLAN).
The HCPLAN is a group of public and private healthcare leaders dedicated to providing thought leadership, strategic direction, and ongoing support to accelerate the adoption of alternative payment models (APMs) and accountable care.
Every year, the HCPLAN conducts a national effort to assess the adoption of APMs over time and track progress towards the HCPLAN’s goals. Since its start in 2015, the Measurement Effort has evolved to incorporate data from a large sample of payers that represents nearly 92% of covered Americans, and now serves as the most comprehensive snapshot available for measuring progress on payment reform. In 2018, the HCPLAN began reporting payment data by line of business (LOB) — Commercial, Medicaid, Medicare Advantage, and Traditional Medicare.
The survey finds continued growth in the adoption of VBC arrangements and shared risk arrangements. Across all lines of business, value-based arrangements grew by nearly 4 percentage points from 41.3% in 2022 to 45.2% in 2023. Shared risk arrangements also saw an increase, growing by 4 percentage points, from 24.5% in 2022 to 28.5% in 2023.
Medicare Advantage (MA) continues to lead in this space with 64.3% of payments in 2023 flowing through value-based arrangements, compared to 42% for fee-for-service (FFS) Medicare. This is a 7.1 percentage point year-over-year increase for MA plans from 57.2% in 2022, compared with a 0.6 percentage point increase for FFS over 2022.
Commercial health plans continue making progress toward value-based adoption. Participation in commercial VBC arrangements grew from 34.6% in 2022 to 39.2% in 2023, a 5.1 percentage point increase. Adoption of downside risk arrangements in the commercial market also saw an increase of 5.1%.
The survey asked respondents for the Top Three Barriers to APM Adoption as Identified by Payers:
1. Provider ability to operationalize
2. Interoperability
3. Provider interest/readiness
The Top Three Facilitators to APM Adoption as Identified by Payers:
1. Provider interest/readiness
2. Health plan interest/readiness
3. Government influence
“The survey’s findings demonstrate a critical way in which health plans are leading the way to promote better care and greater affordability for patients,” said Danielle Lloyd, M.P.H., AHIP’s senior vice president of private market innovations and quality initiatives for clinical affairs, in a statement. “Through the increased adoption of value-based care and innovative payment models, health plans are delivering on their promise to improve quality and care coordination while prioritizing prevention and managing costs.”
