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.
Brian Pieninck, President & CEO, CareFirst BlueCross BlueShield
Lee Sacks, Retired CMO, Advocate Aurora Health
Jean Drouin, MD, CEO, Clarify Health
Jed Kay, VP Healthcare Strategy, MetaCX
Nitin Thakor, President & CEO, GeBBS Healthcare Solutions
Sachin Patel, CEO, Apixio
Miles Snowden, MD, EVP, Physician Strategy, Navvis
Yousuf Zafar, SVP, Medical Informatics, Change Healthcare
Bruce Bodaken, Blue Shield of California
Caroline Carney, MD, Magellan Health
Norman Chenven, MD, Austin Regional Clinic
Jean Drouin, MD, Clarify Health Solutions
Mary Grealy, Healthcare Leadership Council
Katie Huber, Duke-Margolis Center For Health Policy
Kris Joshi, Change Healthcare
Harlan Levine, City of Hope
Barbara McNeil, MD, PhD, Harvard Medical School
Rhonda Medows, MD, Ayin Health Solutions
Farzad Mostashari, MD, Adelade
Griffin Myers, Oak Street Health
Brian Pieninck, CareFirst BlueCross BlueShield
Rachel Roiland, PhD, Duke-Margolis Center For Health Policy
Lee Sacks, MD, Advocate Aurora Health
Paul Scheel, Washington University School of Medicine
Nitin Thakor, GeBBS Healthcare Solutions
Susan Turney, Marshfield Clinic Health System