Value-Based Payment Reform

Research and resources connected with the national movement to advance value-based payment in health care.

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Historically, health care payment in the United States has been driven by a fee-for-service model in which payments to health care providers are tied to the volume of services that patients receive. Amid growing evidence of inefficiencies and poor health outcomes stemming from this model, a movement has emerged which is advancing new models of health care payment that instead link providers’ reimbursements to the value of the services they provide, both to individual patients and broader patient populations.

From a national to a local level, the payment reform movement brings together stakeholders across the health care system who have a shared interest in using value-based payment models to improve clinical quality and outcomes, while also containing or reducing health care costs. These approaches range from accountable care organizations and patient-centered medical homes, which encourage innovative payment approaches that center around health care value, to different approaches of linking payments for multiple services provided to a patient during a single episode of care.

With a broad coalition of policymakers, providers and insurers, the Robert Wood Johnson Foundation is helping to advance promising models of payment reform and value-based payment and care. As we learn from these efforts, this collection offers key findings and perspectives on the effectiveness of different payment models, to inform continued research, testing, and innovation.

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Medicare's Evolving Approach to Paying for Primary Care

December 7, 2017 | Brief

Urban Institute brief reports relatively few physicians go into primary care in the U.S. partly because of large disparities in the salaries of primary care physicians and specialists.

Comments from Richard Besser, MD, on Center for Medicare and Medicaid Innovation Center New Direction on Patient-Centered Care and Market-Driven Reforms

November 20, 2017 | News Release

Comments were submitted to the Centers for Medicare & Medicaid Services, by Richard Besser, MD, RWJF President and CEO, in response to the agency’s request for comments.

Analysis of Integrated Delivery Systems and New Provider-Sponsored Health Plans

June 1, 2017 | Report

Researchers find the current health plan environment is not conducive to profitability for new provider-sponsored plans. Given proposed cuts to Medicaid and changes to plans in AHCA, the remaining plans face more uncertainty.

Robert Wood Johnson Foundation Comments on Pediatric Alternative Payment Model Concepts and Approaches to Improve Pediatric Care

March 28, 2017 | News Release

Risa Lavizzo-Mourey, former RWJF president and CEO, shares comments on Pediatric Alternative Payment Model concepts in response to a request by the Centers for Medicare & Medicaid Services.

Evaluation of Value-Based Payment Models

December 1, 2016 | Brief

The value-based payment approaches were evaluated by University of Washington researchers. Executive summaries of the evaluations of each of these projects examine the experiences of eleven independent multi-stakeholder initiatives in eight states

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