Abstract
Health care in the US remains challenged by affordability, availability, and wasteful spending. To address these challenges, the various constituents in health care payment and delivery all seek to reduce total cost of care while maintaining or improving the relevant clinical outcome expected (value-based care). It is generally acknowledged that health care is not one system but is, in fact, fragmented in control and delivery between local and national commercial payers, government payers, employers, private and public providers, and drug and device manufacturers, all of whom are overseen by state and federal regulations. To help guide further discussion on current and evolving value-based care strategies, this paper provides insights and perspective from each constituent involved in shaping health care payment and delivery throughout the US.
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