Among commercial health plans, 40 percent of payments to physicians and hospitals are now designed to incentivize quality improvement and waste reduction, according to the 2014 National Scorecard on Payment Reform from Catalyst for Payment Reform, a nonprofit corporation that works on behalf of large employers and other healthcare purchasers.
By contrast, CPR's 2013 scorecard showed just 11 percent of payments in the commercial sector were tied to value. The scorecard is based on data voluntarily submitted by commercial health plans representing 65 percent of the commercially insured lives in the U.S.
Of the value-based payment models in action, 53 percent put providers at some financial risk if they fail to contain costs or improve care, according to CPR. However, the scorecard shows many value-based payments fall into the category of pay-for-performance (which offers providers only potential financial rewards and no risk).
Furthermore, value-based payments affect hospitals the most: Thirty-eight percent of payments to hospitals from the insurers included in the scorecard are value-oriented, compared with 24 percent of payments to primary care physicians and 10 percent of payments to specialists in outpatient settings.
Finally, the scorecard shows 15 percent of the participating health plans' patients are formally "attributed" to providers in payment reform contracts, such as accountable care organizations. That's a significant increase from just 2 percent of patients in 2013, according to CPR.