Design and impact of value-based payment: a scoping review of schemes implemented or active between 2010 and 2024
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1İzmir Bakırçay University, Health Sciences Faculty, Health Management Department, Gazi Mustafa Kemal Mahallesi, Kaynaklar Caddesi Seyrek,Menemen, İzmir, Türkiye.
Background:
Value-based payment (VBP) schemes have emerged as alternatives or complements to traditional payment models, to realign financial incentives toward quality, efficiency, and patient-centered outcomes. Despite their rapid expansion, no recent review synthesizes both design features and reported impacts.
Objective:
To provide an overview of recent VBP schemes, highlighting policy objectives, design parameters, and reported impacts, without focusing on specific countries or care settings.
Methods:
A scoping review was conducted following JBI methodology. Searches in Medline (via PubMed) and Web of Science identified English-language peer-reviewed articles, systematic or scoping reviews published between January 2015 and July 2024. The review focused on large-scale VBP schemes implemented after 2010 or active between 2010 and 2024. Studies were included if they described a VBP scheme and/or evaluated its impact using quantitative evaluation methods. Gray literature supplemented information on identified models.
Results:
We identified 61 VBP schemes across 15 countries: 38 pay-for-performance, 18 bundled payment, and 5 shared savings. Common objectives included improving cost efficiency (40%) and care coordination (38%). One-third targeted multiple care settings, and about half focused on multiple conditions. Among the 41 VBP schemes that underwent impact evaluation, positive effects were most frequently observed for clinical process (n = 14), followed by efficiency (n = 11), patient outcomes (n = 11).
Conclusion:
Although VBP schemes hold considerable promise, the ability of these programs to deliver desired outcomes depends heavily on their specific design and the context in which they are implemented. Continuous evaluation and iterative refinement are essential to ensure these programs achieve measurable improvements in quality, efficiency, and patient experience.
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