Harvard expert: simplify APMs, make benchmarks predictable

Dr. Mike Chernu, professor of health care policy at Harvard Medical School, told PTAC the core value of alternative payment models is shifting risk and giving providers flexibility to find efficiencies, not imposing detailed clinical micromanagement. Chernu warned that a proliferation of overlapping programs confuses providers and reduces the effectiveness of APMs.

"Alternative payment models are a tool. They're not an end," Chernu said, urging a ‘‘north star’’ of flexibility and simpler program design. He emphasized that how waste is assigned and how benchmarks are set will fundamentally determine provider incentives to participate. Chernu recommended population‑based models as the default, with episode or nested models added only where they clearly support systemwide goals.

He also flagged a practical governance issue: benchmarks and predictability matter more to provider participation than many aspirational design features. Chernu recommended that PTAC prioritize design clarity and interoperability of models to avoid the clutter that undermines long‑term adoption.