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Leveraging Value-Based Payments to Increase Health Care Value & Resilience

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Work Group Charter

Health care systems implementing value-based payment (VBP) care models have demonstrated their potential for improving efficiency and patient outcomes by reducing hospitalizations, specialty care and emergency room visits.  However, despite years of public policy and private market efforts, VBP arrangements represent the minority of reimbursement to the industry, and most health care systems have numerous specific, often conflicting, VBP arrangements from health plans, Medicare and other contractors.  Beyond this, only a small share of VBP arrangements are two-sided, containing both incentives for better performance and downsides for worse performance.  Although the steady revenue stream from VBP arrangements has given some relief to at-risk providers during the COVID-19 pandemic, the future of VBP arrangements in a future of austerity and profound access-to-care issues is uncertain.  The overarching goal of this Work Group is to increase the prevalence of VBP arrangements among providers and payers by identifying and reducing barriers to adoption in order to improve efficiency and patient outcomes.

Co-Chairs

  • Brian Pieninck, President & CEO, CareFirst BlueCross BlueShield

  • Lee Sacks, Retired CMO, Advocate Aurora Health


Industry Advisers

  • Kris Joshi, EVP & President, Network Solutions, Change Healthcare

  • Nitin Thakor, President & CEO, GeBBS Healthcare Solutions

Work Group Partners

Work Group Fellows

Tracy Bahl, The Bahl Group

Jonathan Breslau, MD, Sutter Medical Group

Norman Chenven, MD, Austin Regional Clinic

Natasha Deckmann, MD, AARP Services Inc.

Esther Dyson, Wellville

Beth Ginzinger, Blue Cross Blue Shield of Arizona

Mary Grealy, Healthcare Leadership Council

Kris Joshi, Change Healthcare

Mark Laret, UCSF Health

Harlan Levine, City of Hope

Barbara McNeil, MD, PhD, Harvard Medical School

Rhonda Medows, MD, Ayin Health Solutions

Randall Moore, MD, Franciscan Health

Griffin Myers, Oak Street Health

Colleen Nicewicz, Groups Recover Together

Brian Pieninck, CareFirst BlueCross BlueShield

Matt Rill, MD, Emergency Resources Group and Telescope Health

Lee Sacks, MD, Advocate Aurora Health

Paul Scheel, Washington University School of Medicine

Michael Shumer, Crucial Care

Nitin Thakor, GeBBS Healthcare Solutions

Susan Turney, Marshfield Clinic Health System

Martha Wofford, DaVita Inc.

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