Value-based payment models

Abstract

The concept of value-based purchasing (VBP) refers to performance-based payment strategies that link financial incentives to health-care provider performance, within a set of defined measures, in order achieve better value by driving improvements in quality and by slowing the growth in health-care spending. These types of models include Accountable Care Organizations (ACOs), hospital value-based purchasing (VBP) programs, bundled payments, and clinically integrated networks (CINs). Accountable Care Organizations (ACOs) are groups of physicians, hospitals, and other health-care service providers who are aligned with a purpose to integrate care and promote accountability for a defined patient population. A clinically integrated network (CIN) is a network of providers who continuously evaluate and modify their clinical practices in accordance with agreed-upon protocols to control costs and improve quality. Value-based purchasing (VBP) is a health-care reimbursement mechanism that is based on hospital performance and improvement in three areas: quality of care, adherence to best clinical practices, and patient experience. To stabilize rising costs while improving population health, a concerted effort to reduce the duplication of services and assist patients in navigating the care system is needed, and value-based purchasing models seek to incent and reward this approach.