Provider Behavior Change and Value-Based Incentives: AJMC® Study Says More Can Be Done to Accelerate Healthcare Transformation

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Research in The American Journal of Managed Care® examines care delivery in physician organizations in California and their experience in value-based payment arrangements.

(CRANBURY, N.J. — February 14, 2019) - The promise of value-based payment (VBP) to transform care delivery in physician organizations (POs) can be enhanced if policy makers and providers consider four strategies to push healthcare delivery to the next level, according to an article in the February issue of The American Journal of Managed Care®, “Are Value-Based Incentives Driving Behavior Change to Improve Value?”

The study was conducted in California, a state that has been a forerunner in creating new ways of trying to deliver better healthcare at lower cost. The authors, from the RAND Corporation, examined care delivery changes among POs participating in the Value Based Pay for Performance program of the California Integrated Healthcare Association, a multistakeholder organization committed to high-value integrated care that improves quality and affordability for patients.

In interviewing and surveying leaders of 40 multispecialty POs, the researchers found that while VBP has promoted primary care redesign, its potential is held back by lack of specialty care redesign, as well as limitations in current health information technology infrastructure, lack of physician cost awareness, and inability to influence specialists who are not exclusive to the PO. Incentives remain small, limiting their effectiveness in driving the significant changes needed to derive large improvements in performance.

Transformation could be advanced by strengthening financial incentives for value; engaging specialists in care redesign and delivering value; enhancing partnerships among POs, hospitals, and payers to align quality and cost actions; strengthening information exchange across providers; and applying other strategies to influence physician behavior.


Addressing those areas can drive behavior change among physicians, which in turn will help speed healthcare transformation.

“To drive greater transformation in care delivery, broader payment reform is required to strengthen incentives for value,” said lead author Cheryl L. Damberg, PhD. “Care delivery is complex, and POs may make greater progress in achieving more substantial performance improvements by creating structural supports to assist frontline providers in delivering appropriate care.”

For the full February issue, click here.

About The American Journal of Managed Care®

The American Journal of Managed Care® (AJMC®) is a peer-reviewed, Medline-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC® family include The American Journal of Accountable Care® and two evidence-based series, Evidence-Based Oncology and Evidence-Based Diabetes Management. These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC® publications, please contact Gil Hernandez at 609-716-7777, ext. 139.

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