Multipayer Alignment Workshop Series

Multipayer Alignment Workshop Series


Project Overview

There is an emerging consensus that successful payment reforms require participation from multiple payers, helping create a critical mass of participants moving the health system in the same direction under a unified set of goals. The recent strategic refresh from CMS and CMMI has prioritized multi-stakeholder alignment in model design, along with a focus on health equity. As this strategic refresh unfolds, there could be valuable opportunities to assess how to apply the successes and challenges of multipayer initiatives so far to future initiatives. In particular, many multipayer initiatives have struggled due to insufficient participation and buy-in for “deep alignment,” where all participants use the same measures or mechanisms. New approaches, perhaps informed by a “directional” approach to alignment and a more concerted focus on data needs, may offer more feasible options for a wider range of organizations to participate the long-run.  

But what does directional alignment entail? What would a successful initiative around directional alignment look like? What supporting elements are needed? Would this make alignment initiatives more palatable to a range of payers and providers? How could CMS and CMMI drive systemwide efforts? 

To establish clarity and begin answering these questions, the Duke-Margolis Center for Health Policy is hosting a Multipayer Alignment Workshop Series with support from Arnold Ventures. This workshop series brings together stakeholders from across the health care system to build out the concept of directional alignment, identify necessary components for success, determine feasibility, and chart plausible paths forward.

Key challenges, recommendations and considerations shared through these workshops will be summarized in a report to be released in the fall of 2022. 

Timeline & Areas of Focus

April 2022: Workshop # 1 on Vision for Multipayer Initiatives and Directional Alignment Approach (Completed)

May 2022: Workshop #2 on Opportunities for Multipayer Progress on Health Equity and Data Supports 

August 2022: Workshop #3 on Operationalizing Framework for Multipayer Initiatives, including the Role of Directional Alignment

Summer 2022: Additional Stakeholder Interviews and Building Framework

Fall 2022: Final Report on New Alignment Initiatives Using Directional Alignment

Duke-Margolis Staff

Robert Saunders

Robert Saunders, PhD

Senior Research Director, Health Care Transformation
Adjunct Associate Professor
Executive Team Member
Margolis Core Faculty

Mark McClellan

Mark McClellan, MD, PhD

Director of the Duke-Margolis Institute for Health Policy
Robert J. Margolis, MD, Professor of Business, Medicine and Policy
Margolis Executive Core Faculty