Value-Based Payment is the New For-Profit Health Care Industry

by Kip Sullivan, Kay Tillow, and Ana Malinow. Published in Truthout, September 8, 2022

(Copyright, Reprinted by permission)

Over the last decade, a new industry has emerged that may eventually contribute as much to administrative waste as the insurance industry does today. This industry has no name. Because the participants in the industry all promote a new scheme known as “value-based payment,” and because they all make money off it, we propose to call the new industry the value-based payment (VBP) industry…

If the experiment with ACOs and other VBP schemes authorized by the ACA had worked as advertised — if it had lowered costs and improved quality — advocates could at least argue that the harm done to medical care, especially to primary care physicians, was offset by improved “value.” But the research over the last decade clearly shows VBP schemes are not lowering costs, are having mixed and trivial effects on health, and are exacerbating health inequities. We are, in short, suffering the worst possible outcomes of the VBP experiment. And yet, with few exceptions, proponents of VBP refuse to concede VBP has failed. The “primary care transformation summit” illustrated this problem.

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