Facilitating and Inhibiting Factors in the Design, Implementation, and Applicability of Value-Based Payment Models: A Systematic Literature Review

Abstract

Evidence on the potential for value-based payment models to improve quality of care and ensure more efficient outcomes is limited and mixed. We aim to identify the factors that enhance or inhibit the design, implementation, and application of these models through a systematic literature review. We used the PRISMA guidelines. The facilitating and inhibiting factors were divided into subcategories according to a theoretical framework. We included 143 publications, each reporting multiple factors. Facilitators on objectives and strategies, such as realistic/achievable targets, are reported in 56 studies. Barriers regarding dedicated time and resources (e.g., an excessive amount of time for improvements to manifest) are reported in 25 studies. Consensus within the network regarding objectives and strategies, trust, and good coordination is essential. Health care staff needs to be kept motivated, well-informed, and actively involved. In addition, stakeholders should manage expectations regarding when results are expected to be achieved.

Barriers and Facilitators to Health-Care Provider Payment Reform – A Scoping Literature Review

“… 7–12 The findings underscore the enormous importance of stakeholder engagement. This is consistent with previous studies, 7 , 21 particularly the “principle of many hands”, which has been cited as one of the key success factors of health reforms. 7 …”

“…Finally, but largely consistent with previous studies, 14 , 21 , 62 , 85 we found that sufficient resources (eg, additional funding, infrastructure, etc.) are an undeniable factor in facilitating provider payment reform.…”

“…are an undeniable factor in facilitating provider payment reform. Previous researchers, such as Leao et al, 21 have found that sufficient infrastructure and advanced health information technology are key factors in the design, implementation, and applicability of VBP models. This is consistent with most of our findings, which indicate that payment reforms require adequate health information systems infrastructure and the associated costs (eg, IT tools, data, etc.).…”

How to facilitate the introduction of value‐based payment models?

“…VBP models may enhance user experience by focusing on patient outcomes, tailoring to individual needs, measuring quality, promoting care coordination, seeking patient feedback, and encouraging shared decision-making with providers. 5 In line with this, understanding the needs of the patients is important. Mapping the patient journey might help recognise similarities between patients, making it easier to classify them into certain patient groups and personalise some aspects of care provided to them, aligned with their needs and preferences.…”

“…We focus on the situation of several payers and providers when a two-way agreement is possible, and we use evidence from a systematic literature review. 5…”