US health care costs are escalating at unsustainable levels across all payers, while a consensus is growing that we are not getting what we pay for. Consumers, providers, and payers are universally calling for reform. The current fee-for-service dominated system does not link payment to quality, but rather rewards volume and intensity of care over efficiency. Many payers, including private employers, insurers, federal and state governments, are moving toward new systems of paying for health care that reward value.
In 2009 the Council of State Governments/Eastern Regional Conference assembled a group of legislative and executive branch health policymakers [Committee Members PDF] to consider new initiatives to link health care purchasing to quality. The committee collected Lessons Learned [Lessons Learned PDF] from stakeholders engaged in quality-based purchasing and developed Guiding Principles [Guiding Principles PDF] for states embarking on such initiatives.
Ellen Andrews, PhD
CSG/ERC
Value Over Volume: Paying for Quality
March 2012
Ellen Andrews, PhD
CSG/ERC
Paying for Quality Health Care: States' Roles
March 2011
Trish Riley, Director
Governor’s Office of Health Policy and Finance
Volume to Value: Quality Based Purchasing for Policymakers
August 2010
Stuart Guterman
Commonwealth Fund
Developing Innovative Payment Approaches: Finding the Path to High Performance
November 2009
Sarah Iselin
MA Commissioner of Health Care Finance and Policy
Massachusetts Health Care Payment System: Recommendations of the Special Commission
October 2009
Frank Johnson
ME State Employee Health & Benefits
The Maine Experience: In Pursuit of Value-Based Purchasing
August 2009
Susan McDonald
MN Health Purchasing Coordinator
Minnesota Value-Based Purchasing
August 2009
Doug Emery
Bridges to Excellence
Economic Principles of Payment Reform
August 2009
Ellen Andrews
CSG/ERC
Paying for Quality Health Care: States’ Roles
August 2009