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

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  Brian Pieninck, President & CEO, CareFirst BlueCross BlueShield

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  Lee Sacks, Retired CMO, Advocate Aurora Health

Industry Advisers

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

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  Nitin Thakor, President & CEO, GeBBS Healthcare Solutions

Work Group Partners