Commercial Payers and Value-Based Care

According to a recent report from the Health Care Payment Learning & Action Network (LAN), interest and participation in value-based care in the commercial sector is increasing with approximately 46% of commercial payments currently tied to value. 

LAN’s 2022 APM Measurement Report, which represents 62% of the national commercial market, says in 2021 value-based care payments were made to physicians and health care providers in these categories (see infographic):

11.8%: fee-for-service incentives with a link to quality and value (Cat. 2)

31.9%: alternative payment models such as shared savings programs (Cat. 3)

2.6%: population-based payments such as total cost of care or capitation models (Cat. 4) 

APM Framework - Figure 1

The following link to information concerning value-based care strategies and policies pursued by major commercial payers in the Texas market:

Aetna/CVS Health
Blue Cross and Blue Shield of Texas
Cigna HealthCare
UnitedHealth Group
Texas Health and Human Services: Cross-Agency Coordination on Healthcare Strategies and Measures

Last Updated On

September 22, 2023

Originally Published On

September 22, 2023