A P4P HEDIS Measure of Prevention: Will MAHA Leaders Bring Transparency to Value-Based Health Care Payment?

During Secretary of Health and Human Services Robert F. Kennedy Jr.’s Senate confirmation hearing, he mentioned the health care payment system that Medicaid, Medicare, and many private payers have been adopting in recent years:

“President Trump has given me the charge of improving quality of care and lowering the price of care for all Americans. There are many things that we can do. . . . The ultimate outcome, I think, is to increase transparency, to increase accountability, and to transition to a value-based system rather than a fee-based system.”

But value-based payment systems, which offer health care providers financial incentives to provide certain services to patients, are not transparent about which services are incentivized. When incentives for providing some services, such as vaccinations, have been brought to light, the public reaction has often been negative.

In this video, I take a look at how value-based payment incentives work and ask whether RFK Jr. and other leaders of the Make America Healthy Again (MAHA) movement will advocate for transparency from payers and providers about which health care services are being incentivized.

I also touch on the expansion of government public health bureaucracy that’s occurring as private organizations join health data networks that are connected to the government.

Sources:

• New York State 2025 Total Care for General Population (TCGP) VBP Quality Measures

• New York State 2024 Quality Assurance Reporting Requirements

• Quality Matters Podcast: Unlocking Value in US Health Care (NCQA Podcast)

• NCQA website

• 2024 Trends Shaping the Health Economy (Trilliant Health report)

• 2017 article: Blue Cross Blue Shield pays your doctor a $40,000 bonus for fully vaccinating 100 patients under the age of 2

• 2016 BCN BCBSM Incentive Program Booklet

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