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Value-based purchasing: the evidence.

Gloria N Eldridge¹, Holly Korda

¹Altarum Institute, Systems Research and Initiatives, Portland, ME 04102, USA.

The American Journal of Managed Care

|August 20, 2011

Summary

Value-based purchasing strategies show promise for improving healthcare value, but evidence on their effectiveness in enhancing health outcomes or reducing costs is still developing. Careful consideration of market factors is crucial for successful implementation.

Area of Science:

Health Services Research
Healthcare Policy
Health Economics

Background:

National healthcare reform emphasizes value-based purchasing (VBP) strategies.
Key areas include service delivery integration, payment reform, and value-based insurance design.
The goal is to improve health outcomes and reduce healthcare costs.

Purpose of the Study:

To review evidence on the effectiveness of VBP strategies.
To determine if VBP can improve health outcomes or reduce healthcare costs.
To inform purchasers about VBP implementation.

Main Methods:

Review of peer-reviewed and field-based research.
Inclusion of strategies such as Accountable Care Organizations, Patient Centered Medical Homes, bundled payments, and value-based insurance design.

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Conducted environmental scans and evidence reviews.

Main Results:

Many VBP approaches are novel in healthcare.
Evidence of performance in improving health outcomes or reducing costs is currently limited.
However, evidence is growing as experience with these approaches increases.

Conclusions:

Purchasers must consider market environments and study assumptions when evaluating VBP strategies.
Caution is advised during implementation.
A new measurement paradigm for cost and quality across the care continuum is needed.