Abstract for: Exploring mental models of value-based payment arrangements in healthcare

Value-based payment (VBP) has become an important concept to reform healthcare delivery by changing incentive structures that shift incentives away from fee-for-service, or volume, to “value”, measured as some function of both quality of care and savings. For such arrangements to steer healthcare delivery to improved quality and efficiency, it is critical that the payer and its VBP Contractor have in place a monitoring and evaluation system which may inform not only payments but also future investments. The project that is the subject of this abstract proposes to build SD models of prototype VBP arrangements that may provide a sort of learning laboratory for stakeholders to begin to surface, test, and refine their hunches about how VBP arrangements may behave under a variety of conditions. The purpose of the Work-In-Progress (WIP) presentation is to share some of the learning opportunities of a base model but to also explore how to fully leverage SD models to elicit questions about structures underlying behavior. Thus, the WIP presentation should be of interest to those with a specific interest in healthcare payment reform as well as to those with a more general methodological interest in SD modeling and learning.