Policy Design Tools For Achieving Equity Through Value-Based Payment, Part 2

Improving health equity in the US will require redesigning value-based payment using a set of coordinated strategies to promote equity alongside clinical, quality, and cost-efficiency outcomes. In part 1 of this article, we articulated the rationale and need for these equity-aligned design changes, and we laid out tools for tackling three design considerations in value-based payment: organizational participation, payment rules, and risk adjustment.

In part 2 below, we extend that work—and ongoing efforts in the Payment Insights Team and the Value & Systems Science Lab to analyze payment model design—by describing a set of tools and related examples corresponding to four additional design considerations: performance measurement, spending targets, performance-based incentives, and care delivery redesign (see exhibit 1).

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