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