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Value-Based Purchasing in Health Care

News Release

Low-Value Care Among Medicare Recipients Drops Only Marginally Despite Effort to Curb Practices

Examples of low-value health care include prescribing opioids for acute back pain and antibiotics for upper respiratory infections. Despite efforts to better educate clinicians and discourage wasteful care, spending on such services among Medicare recipients dropped only marginally from 2014 to 2018.

Feb 16, 2021
Journal Article

Anesthesiologists and the Transformation of the Healthcare System: A Call to Action

This is the second in a series of six editorials on the changing definitions of safety across the perioperative period and how anesthesiologists can participate in and lead the transformation of health care with focus on patient value.

Dec 18, 2020
Journal Article

How Are Medical Groups Identified as High Performing? The Effect of Different Approaches to Classification of Performance

To accurately identify "high-performing providers", a standard definition of high-performance and an agreed-upon approach to measurement are necessary.

Jul 24, 2019
Journal Article

What Defines a High-Performing Health System: A Systematic Review

Lack of a consistent definition of a high-performing health system severely hampers our ability to compare delivery systems based on performance.

Aug 15, 2017
Journal Article

Association Between Hospitals' Engagement in Value-Based Reforms and Readmission Reduction in the Hospital Readmission Reduction Program

Hospitals participating in one or more voluntary Medicare value-based reform programs were less likely to readmit patients within 30 days of discharge than non-participating hospitals.

May 23, 2017
Journal Article

Understanding the Role Played by Medicare's Patient Experience Points System in Hospital Reimbursement

Patient experience points related to improvement and consistency have a small but important effect on payments to hospitals serving large proportions of disadvantaged patients under the Medicare Hospital Value-Based Purchasing program.

Sep 15, 2016
Journal Article

How Can We Improve the Efficiency of Specialty Care?

Four strategies could be helpful in determining the "right" number of specialty care visits--and reducing unnecessary spending.

Jul 19, 2016
Report

Introducing Value-Based Purchasing into TRICARE Reform

Congress is considering how to update TRICARE, the U.S. Department of Defense health benefits program. In this Perspective, the authors evaluate two existing proposals that incorporate value-based purchasing and describe a hybrid alternative.

Apr 19, 2016
Report

Medical Device Innovation in the Era of the Affordable Care Act

Changing incentives in the health care sector and the move to value-based payment models will force device manufacturers to redirect investments from the spectacular toward the prudent—lower cost, less sexy.

Feb 8, 2016
News Release

Medical Home Intervention with Shared Savings Shows Quality and Utilization Improvements

A medical home intervention that paid bonuses to physician practices based on financial savings showed significant improvements in quality and use of some medical services relative to comparison practices.

Jun 1, 2015
Blog

Five Years of the Affordable Care Act

The Affordable Care Act has officially been part of the U.S. health care landscape for five years. We reflect on the twists and turns that followed its passage and the RAND research that informed debates along the way, and look ahead to the future of the ACA.

Mar 23, 2015
News Release

Promise of Value-Based Purchasing in Health Care Remains to Be Demonstrated

After a decade of experimentation with reforms that give health providers financial incentives to improve performance, relatively little is known about how to best execute such strategies or judge their success.

Mar 4, 2014
Report

Measuring Success in Health Care Value-Based Purchasing Programs: Summary and Recommendations

Reviews what has been learned over the past decade about performance-based payment strategies in health care and offers recommendations for the design, implementation, and monitoring and evaluation of value-based purchasing programs.

Mar 4, 2014
Report

Promise of Value-Based Purchasing in Health Care Remains to Be Demonstrated

After a decade of experimentation with reforms that give health providers financial incentives to improve performance, relatively little is known about how to best execute such strategies or judge their success.

Mar 4, 2014
Testimony

Efforts to Reform Physician Payment by Tying Payment to Performance

Public and private sector purchasers are actively working to design value-based payment programs to achieve the goals of improved quality and more efficient use of health care resources. How these programs are designed is a complex undertaking and one that will determine the likelihood of their success.

Feb 14, 2013
Journal Article

How Well Do Medicare's Pay-for-Performance (P4P) Programs Match Desirable P4P Design Criteria?

Alignment with best P4P practices varies across Medicare programs; the program for Medicare Advantage aligns most strongly. It is unclear which P4P design elements are critical for quality improvement. Unintended consequences of design features are poorly understood.

Jan 1, 2013
Research Brief

Providers Influence the Bulk of Health Care Spending in the U.S.

Providers can dramatically improve American health care by focusing on “value” instead of “volume,” eliminating wasteful and inappropriate care, applying the best available evidence to their practices, and enhancing patient safety.

Nov 15, 2012
Report

Addressing Medicare Payment Differentials Across Ambulatory Settings

Medicare's payment for physician work and malpractice liability expenses is the same regardless of where a service is provided, but payments differ for facility-related components of care.

Sep 30, 2011
News Release

Investment in New Health Care Quality Measures Needed as Cost-Cutting Strategies Grow

As the health care industry, employers, and government officials seek to control the growth of health spending, new efforts are needed to develop and refine quality-of-care and other performance measures that can assure changes will improve medical care and do not harm patients.

Feb 22, 2011
Report

Investment in New Health Care Quality Measures Needed as Cost-Cutting Strategies Grow

Health care spending reforms should be met with new efforts to develop and refine quality of care and other performance measures in order to assure that any changes will improve medical care and not harm patients.

Feb 22, 2011

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