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Most value-based payment programs have failed to significantly reduce healthcare spending or improve the quality of care for patients. Many have actually resulted in higher healthcare spending, and some have made it harder for patients with complex conditions to receive adequate care.
The reason current programs have failed is that payers have tried to create “incentives” for physicians, hospitals, and other healthcare providers to reduce spending without providing the resources and flexibility those providers need to improve the way they deliver services to their patients. The solution is not to increase the financial risk for providers in these incentive programs, but to take a fundamentally different approach.
Value-based payment will only be successful if it is explicitly designed to support value-based care. Providers deliver care, not payers, so value-based payments must be designed to ensure that providers are able to deliver high-value services to their patients.