Chapter 8.E.4: Value-Based Payment Innovations

To insert after Ch. 8.E.4 (p. 854):

For an overview of initial ACO performance (note 1), see Zirui Song & Elliott Fisher, The ACO Experiment in Infancy: Looking Back and Looking Forward, 316 JAMA 705 (2016). 

For discussions of pay for performance (note 2), see Katrice Bridges Copeland, Health Care Fraud and the Erosion of Trust, 118 Nw. U. L. Rev. 89 (2023); Nita Garg, Hospital Value Based Purchasing and the Bundled Payment Initiative Under the Affordable Care Act: A Good Start, But Is it Good Enough?, 22 Ann. Health L. 171 (2013); Christopher Robertson, Susannah Rose & Aaron S. Kesselheim, Effect of Financial Relationships on the Behaviors of Health Care Professionals: A Review of the Evidence, 40 J. L. Med. & Ethics 452 (2012); Adam Candeub, Contract, Warranty and the Patient Protection and Affordable Care Act, 46 Wake Forest L. Rev. 45 (2011); David M. Cutler, Your Money or Your Life: Strong Medicine for America’s Health Care System (2004); Institute of Medicine, Rewarding Provider Performance: Aligning Incentives in Medicare (2006); David Hyman, Follow the Money: Money Matters in Health Care, Just Like Everything Else, 36 Am. J. L. & Med. 370 (2010); David A. Hyman & Charles M. Silver, The Poor State of Health Care Quality in the U.S.: Is Malpractice Liability Part of the Problem or Part of the Solution?, 90 Cornell L. Rev. 893 (2005); Bruce C. Vladeck, If Paying for Quality Is Such a Bad Idea, Why Is Everyone for It?, 60 Wash. & Lee L. Rev. 1345 (2003).

For discussions of MACRA (note 2), see Health Policy Brief, Medicare’s New Physician Payment System (Health Affairs, April 2016); Eric C. Schneider & Cornelia J. Hall, Improve Quality, Control Spending, Maintain Access — Can the Merit-Based Incentive Payment System Deliver?, 376 New Eng. J. Med. 708 (2017); Peter Hussey et al., The Medicare Access and CHIP Reauthorization Act: Effects on Medicare Payment Policy and Spending, 36 Health Affairs 697 (2016); Jonathan Oberlander & Miriam J. Laugesen, Leap of Faith — Medicare’s New Physician Payment System, 373 New Eng. J. Med. 1185 (2015).

For an especially thorough analysis of paying for episodes of care (note 3), see William M. Sage, Assembled Products: The Key to More Effective Competition and Antitrust Oversight in Health Care, 101 Cornell L. Rev. 609 (2016). See also Michael E. Porter & Elizabeth Olmsted Teisberg, Redefining Health Care: Creating Value-Based Competition on Results (2006); Karen Davis, Paying for Care Episodes and Care Coordination, 356 New Eng. J. Med. 1166 (2007); Francois de Brantes et al., Building a Bridge from Fragmentation to Accountability: The Prometheus Payment Model, 361 New Eng. J. Med. 1033 (2009); Francois de Brantes et al., Should Health Care Come with a Warranty?, 28(4) Health Aff. w674 (July–Aug. 2009); Symposium, 28(2) Health Aff. w205 (Jan. 2009); Symposium, 28(5) Health Aff. 1372 (Oct. 2009); Symposium, 29 Health Aff. 1284 (2010); Symposium, 30 Health Aff. 378 (2012).