Alternative Payment Methods


Alternative Payment Methods include

  • Global payments
  • Limited budgets
  • Bundled payments
  • Other non-FFS based payments

For More Information on Alternative Payment Methods (APMs),
see CHIA's 2017 Annual Report

chia annual report 2017 cover

The Center for Health Information and Analysis (CHIA) collects and reports data on Alternative Payment Methods (APMs). APMs are methods of payment used by payers to reimburse providers not solely based on a fee-for-service (FFS) basis in which some of the financial risk associated with both the occurrence of medical conditions as well as the management of those conditions is shifted from payers to providers to incentivize efficiency and quality of health care delivery. With the enactment of Chapter 224 of the Acts of 2012, CHIA is statutorily mandated to collect and report APM data from private and public health care payers operating in the Massachusetts health care market.

While FFS remains the dominant type of payment method utilized in the Commonwealth, APMs have been implemented in recent years among commercial, Medicaid, and Medicare populations.

 

Key Findings from the 2017 Annual Report

  • Adoption of APMs grew by 6.3 percentage points in the commercial market in 2016, driven by a 13.5 percentage point increase among PPO members.

 

  • Commercial APM adoption increased from 1.1% of PPO members in 2015 to 14.7% of PPO members in 2016.

 

 Alternative Payment Methods (APMs) in Massachusetts

Previous Alternative Payment Methods Publication Materials