Retrospective of value-based care

by jerry on October 25, 2019
For at least the past several years, Medicare has been pushing the idea of value-based payments, where instead of paying doctors for procedures, it would pay doctors for patients' health. The idea is that there are some actions that physicians can take earlier on to prevent patients' health from deteriorating to a point that would require expensive procedures. Under the old payment model, doctors generally lacked the financial incentive to perform those preventative measures (which were arguably often undervalued). With the new payment model, the theory is that providers could do better financially if their patients stayed healthier. Last month, The New York Times published a piece that took a look back over the last several years to see if Medicare's shift in payment model made a difference. Unfortunately, the answer appears to be not much difference (one study concluded "no effect from financial incentives of the program on quality of care or patient satisfaction"), perhaps saving "a modest amount of money."

The piece linked to a number of studies to support the overall conclusion. However, it seems like there is insufficient research to conclude whether the entire approach is ineffective (e.g. impossible to create good metrics) or whether it is just the implementation that is flawed (e.g. too little incentive or too many goals in too short of a time).