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Over the past decade, adoption of value-based payment (VBP) models has increased substantially. The Center for Medicare and Medicaid Innovation’s has launched multiple new models since its authorization, commercial payers have structured almost one-third of their payments as alternative payment models (APMs), and state Medicaid programs have increasingly included payment reforms in their waivers and Medicaid managed care contracts.
Nevertheless, questions remain on how payment and care reforms can best reduce overall costs and improve quality, outcomes, and people’s experience of care. Overall evidence on cost and quality outcomes of the diverse reforms to date is mixed, with some payment models performing better than others. A recent assessment from the Centers for Medicare and Medicaid Services (CMS) has also raised questions about the impact of many of the pilot reforms implemented by the Center for Medicare and Medicaid Innovation (CMMI) during its first decade.