Tags

Type your tag names separated by a space and hit enter

Current State of Value-Based Purchasing Programs.
Circulation. 2016 May 31; 133(22):2197-205.Circ

Abstract

The US healthcare system is rapidly moving toward rewarding value. Recent legislation, such as the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act, solidified the role of value-based payment in Medicare. Many private insurers are following Medicare's lead. Much of the policy attention has been on programs such as accountable care organizations and bundled payments; yet, value-based purchasing (VBP) or pay-for-performance, defined as providers being paid fee-for-service with payment adjustments up or down based on value metrics, remains a core element of value payment in Medicare Access and CHIP Reauthorization Act and will likely remain so for the foreseeable future. This review article summarizes the current state of VBP programs and provides analysis of the strengths, weaknesses, and opportunities for the future. Multiple inpatient and outpatient VBP programs have been implemented and evaluated; the impact of those programs has been marginal. Opportunities to enhance the performance of VBP programs include improving the quality measurement science, strengthening both the size and design of incentives, reducing health disparities, establishing broad outcome measurement, choosing appropriate comparison targets, and determining the optimal role of VBP relative to alternative payment models. VBP programs will play a significant role in healthcare delivery for years to come, and they serve as an opportunity for providers to build the infrastructure needed for value-oriented care.

Links

PMC Free PDF

Authors+Show Affiliations

Chee TT
From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.).
Ryan AM
From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.).
Wasfy JH
From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.).
Borden WB
From Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC (T.T.C., W.B.B.); Department of Health Policy, University of Michigan, Ann Arbor (A.M.R.); and Cardiology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (J.H.W.) wborden@mfa.gwu.edu.

MeSH

Accountable Care OrganizationsHumansPatient Protection and Affordable Care ActProspective Payment SystemReimbursement, IncentiveUnited StatesValue-Based Purchasing

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

27245648

Citation

Chee, Tingyin T., et al. "Current State of Value-Based Purchasing Programs." Circulation, vol. 133, no. 22, 2016, pp. 2197-205.
Chee TT, Ryan AM, Wasfy JH, et al. Current State of Value-Based Purchasing Programs. Circulation. 2016;133(22):2197-205.
Chee, T. T., Ryan, A. M., Wasfy, J. H., & Borden, W. B. (2016). Current State of Value-Based Purchasing Programs. Circulation, 133(22), 2197-205. https://doi.org/10.1161/CIRCULATIONAHA.115.010268
Chee TT, et al. Current State of Value-Based Purchasing Programs. Circulation. 2016 May 31;133(22):2197-205. PubMed PMID: 27245648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current State of Value-Based Purchasing Programs. AU - Chee,Tingyin T, AU - Ryan,Andrew M, AU - Wasfy,Jason H, AU - Borden,William B, PY - 2016/6/2/entrez PY - 2016/6/2/pubmed PY - 2016/12/15/medline KW - costs and cost analysis KW - outcome assessment (health care) KW - reimbursement mechanisms KW - value-based purchasing SP - 2197 EP - 205 JF - Circulation JO - Circulation VL - 133 IS - 22 N2 - The US healthcare system is rapidly moving toward rewarding value. Recent legislation, such as the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act, solidified the role of value-based payment in Medicare. Many private insurers are following Medicare's lead. Much of the policy attention has been on programs such as accountable care organizations and bundled payments; yet, value-based purchasing (VBP) or pay-for-performance, defined as providers being paid fee-for-service with payment adjustments up or down based on value metrics, remains a core element of value payment in Medicare Access and CHIP Reauthorization Act and will likely remain so for the foreseeable future. This review article summarizes the current state of VBP programs and provides analysis of the strengths, weaknesses, and opportunities for the future. Multiple inpatient and outpatient VBP programs have been implemented and evaluated; the impact of those programs has been marginal. Opportunities to enhance the performance of VBP programs include improving the quality measurement science, strengthening both the size and design of incentives, reducing health disparities, establishing broad outcome measurement, choosing appropriate comparison targets, and determining the optimal role of VBP relative to alternative payment models. VBP programs will play a significant role in healthcare delivery for years to come, and they serve as an opportunity for providers to build the infrastructure needed for value-oriented care. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/27245648/Current_State_of_Value_Based_Purchasing_Programs_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓48 ↑32]

Related Citations

More