National Academy of Medicine

Value Incentives and Systems Approaches

Bringing together medicine and engineering for systems-based solutions

VISIC brochure

James Madara, MD (Co-Chair)

James Madara, MD (Co-Chair)

Susan DeVore, MM (Co-Chair)

Susan DeVore, MM (Co-Chair)

Health care in the United States is, in many circumstances, the best in the world. Yet we pay more for health care relative to other nations to get results that, on a population basis, are just mediocre. The prevailing approach to payment and design for health care—which focuses predominantly on fees for individual services rendered—lies at the center of the issue. Application of basic systems engineering principles can improve value achieved by healthcare by better integrating and aligning the multiple processes in play. Some promising initiatives are developing to redirect incentives away from volume and toward value (e.g., value-based payment design, pay for performance, bundled payments). However, there remains a need to advance the implementation of these initiatives in a coordinated and systemic way. The utility of systems-based solutions is well-documented, and will be essential to advancing the coordinated implementation of and collaboration around value-based delivery models.


  • Participants

    Participants include experts from public and private organizations with prominent activities and leadership responsibilities related to development and application of system-based tools and processes for improving health and health care. The aim is for an inclusive Collaborative — without walls — and participation in individual projects is structured according to interest, need, and practicality.

    Representative Participants

    Aetna, Inc.
    American Academy of Family Physicians
    American Academy of Pediatrics
    American College of Cardiology
    American College of Clinical Pharmacy Applied Physics Laboratory
    AstraZeneca Pharmaceuticals LP
    Blue Cross Blue Shield Association
    Brigham and Women’s Hospital
    C-Change Cigna, Inc.
    Commonwealth Fund
    Consumer Reports
    Consumers Union
    Dartmouth-Hitchcock Medical Center
    Epic Systems
    Geisinger Health System
    General Electric Company
    Gordon & Betty Moore Foundation
    Group Health Cooperative
    Harvard University
    HCA, Inc.
    Healthcare Leadership Council
    IBM Institute for Healthcare Improvement
    Institute for Healthcare Optimization
    Johns Hopkins School of Medicine
    Johnson & Johnson
    Kaiser Permanente
    Marriott International
    Massachusetts Institute of Technology
    Massachusetts General Hospital
    Mayo Clinic
    MedStar Health
    National Academy for State Health Policy
    National Business Group on Health
    National Committee for Quality Assurance
    National Health Council National Partnership for Women & Families
    National Patient Safety Foundation
    National Quality Forum
    Northeastern University
    Northwest Physicians Network
    Partners HealthCare System
    Premier, Inc.
    President’s Council of Advisors on Science & Tech.
    Purdue University
    Regenstrief Center on Healthcare Engineering
    Robert Wood Johnson Foundation
    Stevens Institute of Technology
    The Brookings Institution
    The Leapfrog Group
    ThedaCare Center for Healthcare Value
    Tucson Medical Center
    University of Arkansas
    University of Connecticut School of Medicine
    University of Michigan
    University of Pittsburgh
    University of Washington
    University of Wisconsin
    Vanderbilt U
    Virginia Mason Medical Center
    Wellpoint, Inc.

    U.S. Department of Health & Human Services
    -Agency for Healthcare Research and Quality
    -Centers for Disease Control and Prevention
    -Centers for Medicare & Medicaid Services
    -Health Resources and Services Administration
    -National Institutes of Health
    -Office of the National Coordinator for HIT
    -Office of the Secretary
    U.S. Department of Defense (Health Affairs)
    U.S. Department of Veterans Affairs


  • Activities

    Projects under way or under consideration include:

    • Making the case for systems approaches in health. Draft a discussion paper that describes the benefits, and identifies the barriers, of applying a systems approach to improving health and health care.
    • Systems approaches in health professional education. Increase the visibility and knowledge of systems approaches among health professionals by developing short modules for medical, nursing, other health professional, and public health education courses.
    • Learning labs. Develop 4 to 5 learning labs that bring together engineering and health care professionals to address important problems that affect health care quality, population health, and health care costs.
  • Upcoming Meetings

For more information, contact Ana Petricel, Senior Program Assistant, at