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- Value-Based Care
Episode 14 - Value-Based Care-Can It Work?
Based on her experience, Maria Lopes, MD, MS, explains that many large employers are adopting a value-based healthcare system. She notes that this may be because larger employers are focused on the long-term benefits of prevention and wellness.
Dr Lopes explains that while some employers offer incentives for meeting certain minimum criteria (eg, getting health risk appraisals), others incorporate value-based benefit designs. In some cases, employers punish employees with disincentives, such as increasing the employee share of the premium increases.
Yehuda Handelsman, MD, FACP, FACE, FNLA, explains that as a result of provider- focused pay-for-performance models of care, physicians may try to avoid treating certain higher-risk patient groups. Dr Handelsman explains that if a physician does not believe that an outcome of improvement for a patient or patient group is possible, there is no incentive to manage them. Jeffrey D. Dunn, PharmD, MBA, notes that most pay-for-performance models are incentive based.
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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