Measuring Success in Health Care Value-Based Purchasing Programs

01/01/2014

(1) Findings from an Environmental Scan, Literature Review, and Expert Panel Discussions
(2) Summary and Recommendations

Abstract/Summary: The Office of Health Policy in the Office of the Assistant Secretary for Planning and Evaluation asked RAND to review what has been learned about performance-based payment models, or Value-Based Purchasing (VBP) programs over the past decade that might help inform policymaking. VBP programs are advancing in response to ACA requirements, including federal initiatives to accelerate redesign of delivery system through performance-based financial incentives. VBP refers to a broad set of performance-based payment strategies that link financial incentives to providersтАЩ performance on a set of defined measures in an effort to achieve better value by driving improvements in quality and slowing the growth in health care spending. The review included pay for performance, ACOs and bundled payment models. The goal of the review was to understand whether VBP programs have been successful, what the elements of successful programs are, and the gaps in the knowledge base that need to be addressed to improve the design and functioning of VBP programs moving forward.

The first findings report summarizes the current state of knowledge on the effectiveness of value-based purchasing (VBP) in public and private sector healthcare programs based on findings from the environmental scan, literature review and discussions from two Technical Expert Panel meetings.

The second summary and recommendations report outlines a set of recommendations regarding the design, implementation, monitoring and evaluation of these programs, which if pursued could help policymakers better understand where and under what conditions VBP works and how to strengthen program design and implementation so that these programs achieve improved value for patients and for payers.