Historically, healthcare payment in the United States has been driven by a fee-for-service model in which payments to healthcare 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 healthcare 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 healthcare system who have a shared interest in using value-based payment models to improve clinical quality and outcomes, while also containing or reducing healthcare costs. These approaches range from accountable care organizations and patient-centered medical homes, which encourage innovative payment approaches that center around healthcare 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.