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A little more than 10 years ago, the passage of the Affordable Care Act (ACA) set the nation’s badly broken healthcare system on a new path. In its bold shift away from the traditional fee-for-service (high volume-focused) payment model, the ACA set the stage for new value-based payment (VBP) models designed to reduce the rate of inappropriate services and sub-optimal care while improving population health outcomes.
Despite delays and setbacks (e.g., congressional efforts to weaken or dismantle the ACA), several VBP initiatives have shown some promise in terms of reduced spending and quality improvement, and participation in VBP short-term models has increased. Nevertheless, the twin issues of cost escalation and suboptimal quality of care persist. And, as the Medicare trust fund plummets, racial and socioeconomic health disparities are amplified.