Value Incentives & Systems Action Collaborative
Financial incentives that drive accountability for population health

About the Value Incentives & Systems Action Collaborative
As one of four action collaboratives under the National Academy of Medicine’s Leadership Consortium, the Value Incentives & Systems Action Collaborative (VISAC) seeks to identify financial incentives that drive individual and community health and well-being.
Despite the high rate of spending on health in the U.S., health outcomes lag behind other industrialized nations. To address this persistent gap between spending and value, the VISAC works with government leaders, industry executives, clinicians, and other critical stakeholders —to identify payment methods that are aligned with shared expectations for health system performance. The VISAC aims to move the U.S. toward a health system that is affordable, efficient, and accessible to everyone.
Co-Chairs

Diane P. Holder is executive vice president and president of the UPMC Insurance Services Division, and president and CEO of UPMC Health Plan. UPMC is one of the nation’s leading integrated delivery systems and through its health plans and affiliates, provides health coverage and benefit management for 3.4 million men, women and children in Pennsylvania. The Insurance Services Division includes the UPMC Health Plan, UPMC for You, Community Care Behavioral Health Organization and Work Partners. These health benefits companies manage benefits for Commercial, Medicaid, Medicare, Behavioral Health, EAP, Health Promotions and Worker’s Compensation programs.
Ms. Holder has held a number of leadership positions in health care including the CEO of UPMC’s Western Psychiatric Institute and Clinic and the founding CEO of Community Care Behavioral Health Organization. Ms Holder is a faculty member of the University of Pittsburgh Department of Psychiatry and a faculty member of Pitt’s Graduate School of Public Health. She received her undergraduate degree from the University of Michigan and her master’s degree from Columbia University.

James L. Madara, MD, serves as the CEO and executive vice president of the American Medical Association, the nation’s largest physician organization. He holds the academic title of adjunct professor of pathology at Northwestern University.
Since taking the reins of the AMA in 2011, Dr. Madara has helped sculpt the organization’s visionary longterm strategic plan. As an extension of this vision, he now also serves as chairman of Health2047 Inc., an independent, design-driven innovation firm based in San Francisco and whose mission is to help advance the AMA’s goal of improving the health of the nation.
Prior to arriving at the AMA, Dr. Madara spent the first 22 years of his career at Harvard Medical School, receiving both clinical and research training, serving as a tenured professor and as director of the NIH-sponsored Harvard Digestive Diseases Center. Following five years as chair of pathology at Emory, Dr. Madara served as dean of the medical school and CEO of the hospitals at the University of Chicago, bringing together the university’s biomedical research, teaching and clinical activities. While there he oversaw the renewal of the institution’s biomedical campus and engineered significant new affiliations with community hospitals, teaching hospital systems, community clinics and national research organizations.
Dr. Madara also served as senior advisor with Leavitt Partners, an innovative health care consulting and private-equity firm founded by former Secretary of Health and Human Services, Mike Leavitt.
Having published more than 200 original papers and chapters, Dr. Madara has received both national and international awards, and served as editor-in-chief of the American Journal of Pathology and as president of the American Board of Pathology.
In addition to Modern Healthcare consistently naming him as one of the nation’s 50 most influential physician executives, as well as one of the nation’s 100 most influential people in health care, he is a past recipient of a prestigious MERIT Award from the National Institutes of Health. He received the 2011 Davenport Award for lifetime achievement
in gastrointestinal disease from the American Physiological Society and the 2011 Mentoring Award for lifetime achievement from the American Gastroenterological Society.
Dr. Madara is an elected member of both the American Society of Clinical Investigation and the Association of American Physicians. He also cochairs the Value Incentives and Systems Innovation Collaborative of the National Academy of Medicine (NAM), and is a member of NAM’s Leadership Consortium for Value & Science-Driven Health Care.
Collaborative Updates
Impact
The Special Publication explores the effects of systems on the following population groups:
Action Collaborative Description
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. Moreover, health care is unaffordable for many in need. The prevailing approach to health care payment—which focuses predominantly on fees for individual services rendered—lies at the center of the issue. While promising initiatives are developing to redirect financial incentives away from volume, there is a need to better align financial incentives with individual and community health goals. While misplaced dollars are the issue, intentionally directing those dollars to value for population health goals is the solution.
Stakeholders
The VISAC seeks to include a wide variety of stakeholder voices to promote and to advance achievement of the LHS Shared Commitments Trust Framework.
- Accountable for Health
- Advent International
- Aetna/CVS Health
- Aledade
- American Medical Association
- Ascension Health
- Baillit Health
- Catalyst for Payment Reform
- Columbia University
- Convergent Ventures
- Dartmouth
- Elevance Health/Anthem
- ExploraMed, Inc.
- Families USA
- General Catalyst
- Georgetown Center on Health Insurance Reforms
- Federal Reserve Bank of New York
- Frist Cressey Ventures
- Harvard University
- Health Care Cost Institute
- Health Quality Advisors LLC
- Hopscotch Primary Care
- Institute for Accountable Care
- Johns Hopkins University
- Johnson & Johnson
- McKesson Ventures
- Medical Home Network
- National Association of Accountable Care Organizations
- National Association of Community Health Workers
- National Association of Medicaid Directors
- National Committee for Quality Assurance
- National Quality Forum
- Nationwide Children’s Hospital
- Nemours Children’s Health
- NYU Grossman School of Medicine Department of Population Health
- Oracle Health
- Oregon Health and Science University
- Patient Square Capital
- Penn LDI
- Purchaser Business Group on Health
- Rethink Health/The Rippel Foundation
- Robert Wood Johnson Foundation
- Simple Healthcare
- Spindletop Capital
- Stanford University
- The Joint Commission
- The Leapfrog Group
- Town Hall Ventures
- Trinity Health
- Tristela Capital Partners
- UnitedHealth Group
- University of Michigan Center for Value-Based Insurance Design
- UPMC Health Plan
- U.S. Department of Defense
- U.S. Department of Health & Human Services
- Agency for Healthcare Research and Quality
- Centers for Medicare & Medicaid Services
- Office of the Assistant Secretary for Technology Policy
- U.S. Department of Veterans Affairs
- U.S. Small Business Administration
- UT Southwestern Medical Center
- Washington Healthcare Authority
Activities
Projects completed, under way, or under consideration by the VISAC include:
- Health Financing and Accountability Workstream: A component of the Commission on Investment Imperatives for a Healthy Nation, this workstream will describe alignment challenges, impacts and opportunities for improvement related to financial incentives, turning them to reward the achievement of individual and community health goals rather than merely volume. Workstream members will produce a background paper that will inform Commission deliberations on the associated opportunities, priorities, and implications dependent on correcting the alignment of values, incentives, policies, and actions.
- Private Investments in Health Workstream: A component of the Commission on Investment Imperatives for a Healthy Nation, this workstream will describe alignment challenges, opportunities, and impacts related to private equity and venture capital investment in health. Workstream members will produce a background paper that will inform Commission deliberations on the associated opportunities, priorities, and implications dependent on correcting the alignment of values, incentives, policies, and actions.
- Measures that Motivate: An analysis focused on aligning the measures that drive most health care payments with individual, community, and national health goals.
Meetings
May 30, 2024
Publications
Contact Information
Questions?
For more information, please contact [email protected].