Value-Based Payment and Health Care System Preparedness and Resilience   [open pdf - 0B]

From the ASPE (Assistant Secretary for Planning and Evaluation) Executive Summary: "Over the past 20 years, Medicare and many private payers have transitioned to policies known collectively as value based purchasing (VBP). In general, these policies condition payment on quality indicators and move away from unconstrained fee for service (FFS) payment. Since the passage of the Affordable Care Act (ACA) in 2010, Medicare has used new authorities to test a variety of alternative payment models that hold providers accountable for cost and quality related to episodes of care or, in the case of accountable care organizations (ACOs), all care provided to beneficiaries. Private payers have also begun to use policies such as reference pricing and tiered provider networks in order to replace administered prices with ones that better reflect competitive influences. The overall objective of these policies has been to improve delivery system performance, improving efficiency in how medical care is delivered to make the system more financially sustainable, and to improve its contribution to population health. [...] The need to think critically about how to approach these policy issues and tradeoffs became apparent in light of the COVID-19 [coronavirus disease 2019] pandemic. The Office of the Assistant Secretary for Planning and Evaluation commissioned RAND to begin the process of developing a policy framework for carefully considering these issues. RAND conducted an environmental scan and a series of semi-structured conversations with 12 health care experts. RAND then synthesized the results of those discussions and the environmental scan into a set of lessons learned from the experience with COVID-19 and other disasters, a preliminary understanding of the larger relationship between VBP and disaster preparedness, response, and resilience (PRR), and a set of potential policy directions to promote PRR."

Report Number:
Contractor Project Report HP-2021-07
RAND Health Care
Retrieved From:
Assistant Secretary for Planning and Evaluation: https://aspe.hhs.gov/
Media Type:
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