Value-based care (VBC) is not a new phenomenon, but has been accelerated in recent years by virtue of the Affordable Care Act (ACA) and the Medicare Access and CHIP Reauthorization Act (MACRA), government-led efforts to improve quality and outcomes, and recognition that growth in healthcare costs is unsustainable. Irrespective of efforts to replace the ACA and recent CMS policy changes that make some VBC models voluntary instead of mandatory, we feel strongly that the core elements of VBC, a payment system tied to outcomes and quality of care delivered, are here to stay.

In this Industry Perspective, TripleTree identifies a framework for what we view as essential capabilities to effectively execute a Population Health Management (PHM) strategy in the era of VBC.