Hospital Value Based Purchasing and the Bundled
Payment Initiative Under the Affordable Care Act:
A Good Start, But is it Good Enough?
The United States spends more per capita on health care than any other
nation; yet, the U.S. does not achieve better health care outcomes compared
to other developed nations. 1 Many of the discussions on how to reform the
health care industry have focused on how to best contain these escalating
costs. One frequent suggestion as how best to accomplish these goals
would be to end the traditional healthcare payment model of fee-for-service.
This model has contributed to the overuse of tests and treatment by
providers for the sake of higher profits, 2 and moreover, this reimbursement
model has no real relationship with provider performance and patient
outcome. 3 One of the proposed solutions to this problem is a
reimbursement model that ties payment to providers with patient outcome
in an attempt to simultaneously decrease healthcare costs and improve