Value-based payments are gaining new attention. But what does it mean?

WASHINGTON – Nearly two decades ago, policymakers had an epiphany: The health care system should pay for value rather than volume. Unfortunately, it’s now less clear than ever what value-based payments entail, and whatever it is, it hasn’t lived up to the hype.

Value-based payments, also called value-based care, are receiving renewed attention in Congress as physicians are increasingly distressed by a Medicare payment system that is not keeping up with inflation.

Lawmakers are considering changes to the way Medicare pays doctors for the first time since Congress passed a law in 2015 that relied heavily on value-based payments. A key committee of the House of Representatives considered the matter last fall. The Senate Finance Committee also held a hearing on physician pay this year and recently published a 30 page paper about possible changes in the system. Congressional Medicare advisers have also studied physician pay. Next month they will give Congress some informal ideas for reform.