Over the past decade, "value-based care" and its corresponding contracts have become extremely popular in the managed care industry. These arrangements are a large and growing area of focus for a variety of health care stakeholders: networks, providers, governments, and employers. There are many examples of major payers adding more value-based care models and Optum is stating that value-based care is "vital for survival." Perhaps it is not surprising, then, that a study by the Catalyst for Payment Reform found that the percentage of commercial payments tied to value-based arrangements grew at least 500% since 2012, and that today most health care payments are tied to value or quality of care.

There is no doubting value-based care's popularity, but the more important question is, does value-based care deliver value? The answer is not always straightforward.

Defining value-based care

The term "value-based care" has multiple manifestations in contracts and arrangements between payers and providers. Broadly, all value-based arrangements revolve around incentives (often referred to as "risk") for 1) following preventative and interventional best practices, 2) using resources efficiently, and 3) avoiding adverse outcomes.