Introducing a method to monitor the impact of introducing value-based payment models; using a Dutch pilot project for coronary artery disease as an example

The adoption of value-based payment (VBP) models is expanding globally as healthcare systems seek to align financial incentives with patient outcomes. However, empirical research on both the intended and unintended consequences of VBP implementation remains limited. This study introduces a systematic approach to monitor the effects of VBP models and presents findings from its first application, using a Dutch outcome-based payment model for coronary artery disease (VBP-CAD) as a case study. The developed methodology integrates online questionnaires and semi-structured interviews to assess the impact of an outcome-based payment model on treatment decision-making, organizational dynamics, and the role of clinical outcomes in hospital management. Additionally, case-mix analyses were conducted using real-world nationwide data to evaluate potential shifts in patient risk profiles following the implementation of the payment model. The results of the case-study demonstrate that the proposed approach was successfully implemented, generating valuable insights into both positive and unintended effects of the VBP model. The systematic approach contributes to the ongoing discourse on optimizing value-based payment structures and ensuring equitable, high-quality care delivery. By applying this methodology in different healthcare settings, stakeholders can enhance their understanding of VBP outcomes.