Related Experiment Video
Updated: Aug 21, 2026
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Performance-based payment models and value-based health care: a semi-systematic review through theoretical lenses
Iara Bernz1, Alessandra Rabelo2, Ana Maria Malik1
1Department of Management, São Paulo School of Business Administration, Fundação Getulio Vargas, São Paulo, SP, Brazil.
Objectives:
To identify and critically examine the theoretical lenses applied in the literature to conceptualize performance-based and value-based payment models, and to analyze how these frameworks explain their behavioral, organizational, and system-level effects.
Methods:
A semi-systematic review was conducted in July 2025 across Web of Science, PubMed/MEDLINE, Embase, LILACS, and CINAHL, using a structured search strategy and transparent selection procedures following PRISMA 2020 reporting principles. Eligible empirical and theoretical studies on value- or performance-based payment were extracted using the ADO (Antecedents, Decisions, Outcomes) framework.
Results:
Studies interpreted incentive effects mainly through incentive theory and principal-agent models, complemented by economics, organizational and institutional theories, implementation science, and ethics. P4P was theorized as a contractual mechanism relying on extrinsic incentives, whereas VBHC was framed as an organizational and normative paradigm requiring care redesign and longitudinal outcome-cost measurement. Theoretical extensions integrated incentive-based payment with chronic care models, disease management, activity-based costing, population health management, and the Quadruple Aim. Institutional and political economy lenses highlighted contextual contingency, while normative theories foregrounded ethical tensions, risks to professional autonomy, workforce well-being, and equity trade-offs.
Conclusion:
Incentive-based payment reforms are not neutral technical instruments but theory-dependent and institutionally mediated interventions that require alignment with care models, governance arrangements, and ethical safeguards.
Systematic Review Registration:
https://osf.io/5kv3w/, Open Science Framework (OSF), identifier 5kv3w.
Related Concept Videos
01:25Models of Health Promotion and Illness Prevention I
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
01:30Health Information Technology and Healthcare Information System
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:29Concepts of Health and Illness
01:18Introduction To Health Care Delivery System
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...