As states work to improve the triple aim of health care – controlling costs, improving quality, and increasing access – many are considering value-based payment models and other initiatives as a potential strategy. In contrast to traditional fee-for-service (FFS) payment models that pay providers according to the volume of services provided and represent the predominant payment system in the United States, value-based care models and other initiatives are intended to incentivize high value care and reward providers based on achievement of quality goals and, in some cases, cost savings.
This four-part series will introduce value-based care concepts and provide state strategies and examples to adopt value-based care in the Medicaid program, in the commercial market, and in multi-payer arrangements, and more. Types of models and key terms referenced throughout the series are defined and described in more detail with considerations for implementation and state examples.