brooke

Value based purchasing (VBP) has fundamentally changed healthcare delivery in the United States by shifting away from fee for service (FFS) models, which reward providers for volume, to systems that incentivize quality, efficiency, and patient outcomes. Programs such as Medicares Hospital Value Based Purchasing and Accountable Care Organizations (ACOs) now tie over one third of Medicare payments to value based arrangements (KFF, 2023). This shift encourages providers to focus on preventive care, chronic disease management, and the reduction of unnecessary procedures.

Care coordination and service integration have notably improved under VBP. The Kaiser Family Foundation notes that ACOs have helped manage costs and improve care for patients with chronic illnesses by fostering collaboration among hospitals, primary care physicians, and specialists. Electronic health records (EHRs) play a crucial role by enabling data driven performance monitoring and identifying gaps in care. Patient centered care has also become a priority, with providers incentivized to increase patient satisfaction and engagement through better communication and shared decision making.

Research further supports the positive impact of VBP. Tseng et al. (2022) report that VBP programs can lead to modest improvements in clinical process measures and patient experiences. However, their findings also show that improvements in patient outcomes, such as reduced mortality, are inconsistent and sometimes limited. KFF data similarly show that while VBP models have contributed to a modest slowdown in healthcare spending growth, disparities persist. Smaller or under resourced providers may struggle with the administrative burden of tracking and reporting quality metrics, and there are concerns that providers might avoid high risk patients to protect their performance scores (KFF, 2023; Tseng et al., 2022).

In summary, value based purchasing is reshaping healthcare in the U.S. by aligning payments with quality and efficiency. While benefits include better care coordination, some cost containment, and a stronger focus on patient experience, ongoing challenges such as administrative complexity, persistent disparities, and variable impact on outcomes need to be addressed for the model to reach its full potential (KFF, 2023; Tseng et al., 2022).