Value-based payment (VBP) arrangements have been championed by policymakers and payers as a way to improve patient outcomes while reducing overall costs, in part by supporting the high-value care that primary care physicians provide. VBP models better support the delivery of cognitive services, such as care coordination and chronic disease management, completed largely outside the 15-minute office visit and not adequately captured in fee-for-service (FFS) reimbursement. FFS payments do not fully support the teams and systems necessary to provide comprehensive primary care in the context of a longitudinal patient relationship, which produces better health outcomes at lower costs.¹ Instead, FFS puts primary care physicians on a hamster wheel of rapid visits, documentation, and billing.²

When properly structured, VBP arrangements recognize that value by providing up-front payments for each patient on a physician's panel and potential shared-savings payments. As an illustrative example, it is estimated that one current group of 10 primary care physicians that influences almost $100 million in health care spending can reap the benefits of up-front payments and fewer administrative burdens in the VBP arrangement it participates in.³