Value-based healthcare payment models: a wolf in sheep's clothing for patients and clinicians

Ann Med. 2024 Dec;56(1):2382948. doi: 10.1080/07853890.2024.2382948. Epub 2024 Jul 24.

Abstract

Value-based healthcare payment models are an alternative insurance payment system that compensates healthcare providers based on their patients' outcomes rather than the individual services healthcare workers provide. This shift from the current fee-for-service model that predominates our medical system has received renewed popularity and attention within organized medicine such as the American Medical Association. Advocates believe that this new payment model will address many of the unsolved issues in healthcare such as medical waste and unsustainable healthcare costs. In practice, however, this model is plagued with a myriad of unresolved issues of its own. In this commentary, we outline these issues and suggest that the intentions of those advocating for value-based payment models are either misguided or disingenuous. We then offer solutions that preserve our current fee-for-service model while making necessary changes that will benefit both physicians and patients nationwide.

Keywords: Value-based healthcare; fee-for-service; health insurance; healthcare efficiency; insurance reform; patient outcome; physician reimbursement; population health; preventative medicine.

MeSH terms

  • Fee-for-Service Plans*
  • Health Care Costs / statistics & numerical data
  • Humans
  • Reimbursement Mechanisms
  • United States
  • Value-Based Health Care* / economics
  • Value-Based Health Insurance / economics

Grants and funding

The author(s) reported there is no funding associated with the work featured in this article.