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Published on: February 16, 2011
Care Transitions and Value-Based Payment Models in the United States
Joshua Calianos1, Jose F Figueroa2
1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
The Medical Clinics of North America
|May 29, 2026
Summary
Value-based payment reforms shift US healthcare from volume to value. These changes impact patient care transitions, affecting costs, quality, and equity.
Area of Science:
- Health Services Research
- Healthcare Policy
- Health Economics
Background:
- Value-based payment (VBP) reforms are transforming US healthcare delivery.
- The focus has shifted from healthcare volume to healthcare value.
- Understanding VBP's impact on patient care transitions is crucial.
Purpose of the Study:
- To evaluate the intersection of four major VBP models with patient care transitions.
- To analyze how VBP incentives influence clinical decision-making and post-acute care.
- To highlight the implications of VBP for healthcare costs, quality, and equity.
Main Methods:
- Analysis of four major value-based payment models.
- Examination of patient transitions: ED to hospital, interhospital, and hospital to skilled nursing facility.
- Assessment of how VBP incentives affect clinician behavior and post-acute care strategies.
Main Results:
- VBP models significantly alter clinician referral patterns and post-acute care choices.
- Incentives within VBP influence decision-making at critical care transition points.
- The study identifies key implications for cost, quality, and equity in healthcare.
Conclusions:
- VBP reforms have profound effects on the coordination and delivery of care during patient transitions.
- Understanding these impacts is essential for optimizing healthcare outcomes and resource allocation.
- VBP strategies must consider their influence on healthcare costs, quality, and equity.
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