Value-Based Care

Executive SummaryRegulations often restrict the range of market choices available to consumers, yet they are promulgated without a quantitative analysis of that cost—a fundamental flaw in regulatory impact analysis. This paper fills the gap by supplying a portable choice-value factor. The factor compares value at the unconstrained mix with regulation-constrained value.

Children, youth, and families have unique health needs, which set the foundation for health across the life course; chronic conditions now affect nearly one in three U.S. children, with disproportionate prevalence in those enrolled in Medicaid and CHIP.

We evaluated both the Center for Medicare and Medicaid Services Innovation Center (CMS Innovation Center) models and the Medicare Shared Savings Program (MSSP) and found that they have generated gross savings for all beneficiaries in the Traditional Medicare program while demonstrating positive impacts on selected quality measures.

Stakeholders broadly recognize the imperative of accessing, exchanging, integrating and using data from across the care spectrum to achieve the goals of value-based care. Though there is increasing evidence data exchange is occurring, less is known about how data are being integrated into workflows and used across the care spectrum.

As required by the IMPACT Act, the second Report to Congress examines the effect of individuals’ social risk factors on quality measures, resource use, and other measures under the Medicare program, as well as analyses of the effects of Medicare’s current value-based payment programs on providers serving socially at-risk beneficiaries and simulations of potential policy options to address these

The objectives of this research effort were to collect feedback through interviews with physicians in small rural practices on the initial implementation of Medicare’s Quality Payment Program in 2017, a new value-based purchasing program for Medicare physicians.

This report, mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 or the IMPACT Act (P.L. 113-185), requires the Secretary, acting through the Assistant Secretary for Planning and Evaluation (ASPE), to conduct research on issues related to socioeconomic status (SES) in Medicare’s value-based payment programs.

ASPE asked RAND to review what has been learned about performance-based payment models, or Value-Based Purchasing (VBP) programs over the past decade that might help inform policymaking. Value-based purchasing programs are advancing in response to ACA requirements, including federal initiatives to accelerate redesign of delivery system through performance-based financial incentives.

This report presents findings from a study that examined how the US government and private philanthropic foundations develop and sometimes coordinate health and social services initiatives domestically and internationally.