Health Affairs April 24, 2024
As noted in Part I, value-based payment (VBP) adoption has been slow. Fee-for-service remains the majority of payment in both traditional Medicare and Medicare Advantage as well as commercial insurance. This slow adoption means that regardless how well-designed a VBP model is and how amply incentivized adoption is, VBP faces still faces significant implementation barriers. We identify three barriers and propose three interrelated solutions.
Implementation Barrier 1: Consolidation And Use of Management Service Organizations
At the core of VBP is the notion of realigning provider incentives to create accountability. That is, physicians must risk losing, or not gaining, something if they perform poorly. In an ideal world, the risk might not be financial but behavioral—risk that can be managed entirely...
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