Value-Based Purchasing — National Programs to Move From Volume to Value


The National Quality Strategy of the US Department of Health and Human Service’s three aims of better health, better care, and lower costs capture Centers for Medicare and Medicaid Services (CMS’s) concept of value (i.e., improved outcomes for individuals and populations at lower costs). While CMS has many tools to support the three aims, value-based purchasing (VBP) is one of the most potentially transformational. In essence, VBP rewards providers who deliver better outcomes in health and health care for the beneficiaries and communities they serve at a lower cost. Shifting to a culture of shared accountability for patient and community outcomes and costs will be a journey for health care professionals and regulators. VBP programs are a step in the transition from a fee-for-service health system to one that is fully accountable for these outcomes. Given the national scope of VBP programs, it is imperative to monitor and evaluate their effects, make adjustments when needed, and provide support to providers and communities that are struggling with improvement. In the final analysis, the United States needs a health system that achieves better health and better care at lower costs, and VBP is a critically important tool for achieving those goals.

Keywords: Value-Based Purchasing, Fee-for-Service Plans, Centers for Medicare and Medicaid Services (U.S.), United States, Goals

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