title: Implementing Value-Based Payment Reform: A Conceptual Framework and Case Examples.
abstract: This article develops a conceptual framework for implementation of value-based payment (VBP) reform and then draws on that framework to systematically examine six distinct multi-stakeholder coalition VBP initiatives in three different regions of the United States. The VBP initiatives deploy the following payment models: reference pricing, "shadow" primary care capitation, bundled payment, pay for performance, shared savings within accountable care organizations, and global payment. The conceptual framework synthesizes prior models of VBP implementation. It describes how context, project objectives, payment and care delivery strategies, and the barriers and facilitators to translating strategy into implementation affect VBP implementation and value for patients. We next apply the framework to six case examples of implementation, and conclude by discussing the implications of the case examples and the conceptual framework for future practice and research.
authors.affiliation: University of Washington, Seattle, WA, USA dconrad@uw.edu.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Conrad
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Vaughn
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Grembowski
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Marcus-Smith
mesh_terms: D018166:Health Care Reform / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D017146:Models, Organizational; D016730:Program Development; D012051:Reimbursement Mechanisms / Q000191:economics / Q000458:organization & administration; D014481:United States; D062505:Value-Based Purchasing / Q000191:economics / Q000458:organization & administration*
keywords: conceptual framework; implementation; value-based payment