The promise and challenge of value-based payment

The promise and challenge of value-based payment
JAMA Internal Medicine; by Daniel K Shenfeld, Amol S Navathe, Ezekiel J Emanuel; 7/24
Fee-for-service (FFS) systems pay physicians and health care institutions based on the number of services provided, whereas value-based payment (VBP) links payment to quality and outcomes. In 2021, the Centers for Medicare & Medicaid Services (CMS) announced the goal to use VBP for all Medicare beneficiaries’ health care by 2030. Some commercial insurers are also aligning their contracts to VBP. This broad alignment stems from increasing recognition that to reduce health care costs, incentives must be realigned to change practice patterns, prioritizing quality and cost lowering over quantity of services... Paying for value rather than more health care is without any question a wise approach. VBP fits with the intrinsic motivation of doing good, which led most physicians to medicine. Yet, achieving this is difficult due to operational and financial challenges inherently associated with the transition to VBP. A more efficient, economical method of assessing the underlying risk of a population and measuring the value and quality of care is needed. Various stakeholders across the public and private sectors are working to realize this vision.