Health Affairs October 24, 2018
In an attempt to shift incentives in the health care system from “volume” to “value,” private insurers, public payers, and purchasers have evaluated various models of payment reform. Of these models, pay-for-performance is the longest standing. While shared savings, shared risk, and bundled payment have garnered a lot of attention, focus on these, in their current iterations, is relatively recent. In contrast, pay-for-performance arrangements date back to the 1990s.
Before and for the short period after the passage of the Affordable Care Act (ACA) in 2010, pay-for-performance was the fastest-growing type of payment reform. However, with the recent focus from Medicare and even commercial payers on population health management, pay-for-performance has since been surpassed by shared savings as the...