Resilience. It’s an under-appreciated word. It’s one of those things that we miss, after we lose something—when it’s too late—when there’s kenopsia.

‘Resilience’ is the word Health Care Payment Learning & Action Network (HCPLAN) uses to describe the promise of alternative payment models (APMs).

To be honest, I never thought of APNs under the light of resilience until HCPLAN’s presentation. They pointed that fee-for-service (FFS)-only providers suffered throughout the pandemic (sometimes fatally) because of the lost revenue due patients not showing up. In contrast, providers that were part of a pre-paid system (APMs) had predictable income so could adopt innovative practices (i.e. greater use of telehealth before the FFS model caught up to let them know that they would get paid for such virtual services). Members of APMs had more freedom to experiment with offerings within the realm of value-based care compared to FFS models.

HCPLAN creates a lofty vision that a resilient payment system can encourage care for the whole person, address social risk factors, and rewards providers for keeping patients healthy.

Can a revamped payment system really usher such a utopian health care system? Or is this overly zealous promise? What are the key 20% elements of the alternative payment model that could make provider organizations 80% more resilient? 

If none of these questions resonate with you, have you ever drawn the connection between APMs and resilience?