Care Transitions and Value-Based Payment Models in the United States.

Abstract

Value-based payment (VBP) reforms have reshaped US health care by shifting accountability from volume to value. In this article, we evaluate how 4 major VBP models-including public reporting programs, pay-for-performance models, episode-based payment models, and population-based payment models-intersect with care transitions of patients, including transitions from emergency department to hospital, interhospital transfers, and hospital-to-skilled nursing facility discharges. We highlight how incentives in VBP models alter clinician thresholds, referral patterns, and postacute care strategies, and importantly, highlight the implications for cost, quality, and equity in health care delivery.