Lack of a consistent definition of a high-performing health system severely hampers our ability to compare delivery systems based on performance.
Value Based Purchasing
The Affordable Care Act (ACA) is expanding payment reform under value-based purchasing (VBP). This approach gives financial incentives to providers who deliver “value” in health care, where value means both the outcomes of care and the costs of delivering it.
There is little publicly available information about how to design a successful VBP program, but program sponsors, especially in the private sector, have learned a lot about VBP from trial and error. Integrating published evidence with the advice of experts, RAND work in this area highlights the features of successful programs and identifies critical knowledge gaps.