William H. Shrank, Robert S. Saunders, Mark McClellan
While considerable uncertainty exists about the future of health care reform in the United States, interest continues to grow in benefit and payment reforms that support models of care that control costs and improve quality. Despite the large number of reforms being implemented, such as bundled episode payments and per-beneficiary payments to primary care groups and integrated health care organizations, evidence on the effectiveness of these “value-based” financing reforms is mixed and limited,1 leading to ongoing questions about how such reforms affect outcomes and costs in various contexts. This makes it difficult to know which initiatives should be scaled up and which need further refinement or replacement to support a more efficient, high-value health care system.
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