RAND Research Topic: Value-Based Purchasing in Health Care 2021-05-14T18:47:25Z Copyright (c) 2021, The RAND Corporation RAND Corporation https://www.rand.org/topics/value-based-purchasing-in-health-care.html Low-Value Care Among Medicare Recipients Drops Only Marginally Despite Effort to Curb Practices RAND Corporation https://www.rand.org/news/press/2021/02/16.html 2021-02-16T08:00:00Z 2021-02-16T08:00:00Z 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. Anesthesiologists and the Transformation of the Healthcare System Laurent G. Glance; Lee A. Fleisher https://www.rand.org/pubs/external_publications/EP68390.html 2020-12-18T12:00:00Z 2020-12-18T12:00:00Z 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. How Are Medical Groups Identified as High Performing? Sangeeta C. Ahluwalia; Cheryl L. Damberg; Ann C. Haas; Paul G. Shekelle https://www.rand.org/pubs/external_publications/EP67926.html 2019-07-24T07:00:00Z 2019-07-24T07:00:00Z To accurately identify "high-performing providers", a standard definition of high-performance and an agreed-upon approach to measurement are necessary. What Defines a High-Performing Health System Sangeeta C. Ahluwalia; Cheryl L. Damberg; Marissa Rose Silverman; Aneesa Motala; Paul G. Shekelle https://www.rand.org/pubs/external_publications/EP67270.html 2017-08-15T10:15:00Z 2017-08-15T10:15:00Z Lack of a consistent definition of a high-performing health system severely hampers our ability to compare delivery systems based on performance. Association Between Hospitals' Engagement in Value-Based Reforms and Readmission Reduction in the Hospital Readmission Reduction Program Andrew M. Ryan; Cheryl L. Damberg; John M. Hollingsworth https://www.rand.org/pubs/external_publications/EP67145.html 2017-05-23T08:00:00Z 2017-05-23T08:00:00Z 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. Understanding the Role Played by Medicare's Patient Experience Points System in Hospital Reimbursement Marc N. Elliott; Megan K. Beckett; William Lehrman; Paul Cleary; Christopher W. Cohea; Laura Giordano; Noah J. Goldstein; Cheryl L. Damberg https://www.rand.org/pubs/external_publications/EP66628.html 2016-09-15T11:00:00Z 2016-09-15T11:00:00Z 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. How Can We Improve the Efficiency of Specialty Care? John N. Mafi; Samuel T. Edwards https://www.rand.org/pubs/external_publications/EP66551.html 2016-07-19T10:00:00Z 2016-07-19T10:00:00Z Four strategies could be helpful in determining the "right" number of specialty care visits--and reducing unnecessary spending. Introducing Value-Based Purchasing into TRICARE Reform Susan D. Hosek; Melony E. Sorbero; Grant R. Martsolf; Ryan Kandrack https://www.rand.org/pubs/perspectives/PE195.html 2016-04-19T06:30:00Z 2016-04-19T06:30:00Z 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. Medical Device Innovation in the Era of the Affordable Care Act Soeren Mattke; Harry H. Liu; Patrick Orr https://www.rand.org/pubs/perspectives/PE176.html 2016-02-08T06:45:00Z 2016-02-08T06:45:00Z 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. Medical Home Intervention with Shared Savings Shows Quality and Utilization Improvements RAND Corporation https://www.rand.org/news/press/2015/06/01.html 2015-06-01T15:16:00Z 2015-06-01T15:16:00Z 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. Medical Home Intervention with Shared Savings Shows Quality and Utilization Improvements Mark W. Friedberg; Meredith B. Rosenthal; Rachel M. Werner; Kevin G. Volpp; Eric C. Schneider https://www.rand.org/pubs/external_publications/EP50719.html 2015-06-01T08:00:00Z 2015-06-01T08:00:00Z 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. Promise of Value-Based Purchasing in Health Care Remains to Be Demonstrated RAND Corporation https://www.rand.org/news/press/2014/03/04.html 2014-03-04T18:40:00Z 2014-03-04T18:40:00Z 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. Promise of Value-Based Purchasing in Health Care Remains to Be Demonstrated Cheryl L. Damberg; Melony E. Sorbero; Susan L. Lovejoy; Grant R. Martsolf; Laura Raaen; Daniel Mandel https://www.rand.org/pubs/research_reports/RR306.html 2014-03-04T07:00:00Z 2014-03-04T07:00:00Z 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. Measuring Success in Health Care Value-Based Purchasing Programs Cheryl L. Damberg; Melony E. Sorbero; Susan L. Lovejoy; Grant R. Martsolf; Laura Raaen; Daniel Mandel https://www.rand.org/pubs/research_reports/RR306z1.html 2014-03-04T07:00:00Z 2014-03-04T07:00:00Z 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. Designing a Performance-Based Incentive Program for Physicians Cheryl L. Damberg https://www.rand.org/pubs/testimonies/CT389z1.html 2013-07-12T14:32:00Z 2013-07-12T14:32:00Z Value-based payment programs may encourage providers to innovate and redesign care delivery, potentially driving improvements in quality and efficiency. How Well Do Medicare's Pay-for-Performance (P4P) Programs Match Desirable P4P Design Criteria? Andrew M. Ryan; Cheryl L. Damberg https://www.rand.org/pubs/external_publications/EP51479.html 2013-06-25T09:22:00Z 2013-06-25T09:22:00Z 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. Efforts to Reform Physician Payment by Tying Payment to Performance Cheryl L. Damberg https://www.rand.org/pubs/testimonies/CT381.html 2013-02-14T07:15:00Z 2013-02-14T07:15:00Z 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. Are Performance-Based Accountability Systems Effective? Evidence from Five Sectors Brian M. Stecher; Frank Camm; Cheryl L. Damberg; Laura S. Hamilton; Kathleen J. Mullen; Christopher Nelson; Paul Sorensen; Martin Wachs; Allison Yoh; Gail L. Zellman; Kristin J. Leuschner https://www.rand.org/pubs/research_briefs/RB9549.html 2013-02-12T15:08:00Z 2013-02-12T15:08:00Z Creating an effective Performance-Based Accountability System (PBAS) requires careful attention to selecting an appropriate design for the PBAS, given the context in which it is to operate, and to monitor, evaluate, and adjust the system, as appropriate. Providers Influence the Bulk of Health Care Spending in the U.S. Peter S. Hussey; Andrew W. Mulcahy; David Lowsky; Ramya Chari; Mary E. Vaiana; Arthur L. Kellermann https://www.rand.org/pubs/research_briefs/RB9690z2.html 2012-11-15T11:00:00Z 2012-11-15T11:00:00Z 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. Addressing Medicare Payment Differentials Across Ambulatory Settings Barbara O. Wynn; Peter S. Hussey; Teague Ruder https://www.rand.org/pubs/technical_reports/TR979.html 2011-10-12T14:55:00Z 2011-10-12T14:55:00Z 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.