All but 4 states have embraced value-based care and payment models

A new report published by Change Healthcare shows that nearly all states in the U.S. have adopted value-based care (VBC) programs, which includes a seven-fold increase in the number of states using them in the last five years. Among the 48 states that have implemented value-based care or payment programs, half of them are multi-payer in scope, says the report, noting that the remaining four have little or no value-based care initiatives in place.

"Based on the report, it's obvious that managed Medicaid programs are actively exploring numerous VBP models, and that states implementing more advanced strategies around healthcare payment transformation will ultimately drive the commercial markets,” said Carolyn Wukitch, senior vice president & general manager, Network and Financial Management, Change Healthcare in a news release.

“Value-Based Care in America: State-by-State” provides a detailed accounting of the value-based and alternative payment landscape in all 50 U.S. states, Puerto Rico, and the District of Columbia. Change Healthcare said in its news release that the information in this year’s report has been updated from data it collected in 2017. Information was compiled using state and federal government resources, input from contractors that participate in state-initiated value-based programs, research reports from healthcare industry analysts, think tanks, public policy and research institutes, and the media.

Key findings in the 2019 report:

·   Six states have well-developed VBC strategies in place four years or more; 34 have initiatives two or more years into implementation; and eight states are in in early stage VBC development.

·   Accountable Care Organizations (ACOs) and ACO-like entities are in place or considered in 22 states, and 16 states established or are planning bundled-payment programs.

·   Three states - New York, Pennsylvania, and Vermont - are noteworthy for the broad scope of their breadth of initiatives, embrace of payment models that involve shared risk, and willingness to test innovative strategies.

The report reflects the variety of innovative value-based care approaches deployed across the U.S. and highlights variation in sophistication, leadership commitment, and resources devoted to the national transition from volume (fee-for-service) to value.