Health Care Payment Reform

A collection of research and and programs that are testing and learning from new health care payment models, with the goal of increasing quality and managing costs.

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About This Collection

The current method of paying for health care is broken. Historically, the health care payment system has been designed to reward the volume of services rather than the value of services that are provided to patients. Additionally, in traditional fee-for-service arrangements, doctors often lose money when they spend time doing things that might matter to a patient’s health but that they cannot bill for.

RWJF supports research and implementation of promising models, such as Accountable Care Organizations (ACOs), that are designed to disrupt the traditional fee-for-service system by holding providers accountable for the costs and quality of care for whole populations of people, and by providing clinicians with more financial flexibility when it comes to how they treat patients. This collection contains research and perspectives that compare how different models of payment reform are being used and how effective they are at increasing quality and managing costs.

Latest Research and Perspectives on Payment Models

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.