Value Incentives & Systems Action Collaborative

Supporting payment systems that incentivize value and population health

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 the most efficient distribution of resources that still incentivizes continuous improvement in population and patient-level health, and supports progress towards high-value payment models throughout the U.S. health system.

Health spending in the U.S. accounts for approximately 18 percent of the GDP and remains one of the leading causes of personal bankruptcy. Despite the high rate of spending on care, health outcomes in the U.S. lag behind other industrialized nations. To address this persistent gap between payment and value, the VISAC works with government leaders, industry executives, and clinicians—among other critical stakeholders—to identify payment methods that incentivize effective care at reasonable costs rather than relying on outdated payment models that promote the volume of care over the value to the patient. The VISAC aims to move the U.S. toward a health system that is affordable, efficient, and accessible to everyone.

Winter 2020 Update  |  Summer 2018 Update

Diane Holder, MS (Co-Chair)

Diane Holder, MS

James Madara, MD (Co-Chair)

James Madara, MD (Co-Chair)

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. 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 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
  • Masimo
  • Massachusetts Institute of Technology
  • Massachusetts General Hospital
  • Mayo Clinic
  • MedStar Health
  • Medtronic
  • Microsoft
  • 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
  • Sanofi-Aventis
  • Stevens Institute of Technology
  • Stryker
  • 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
  • U.S. Department of Defense (Health Affairs)
  • 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 Veterans Affairs
  • Vanderbilt U
  • Virginia Mason Medical Center
  • Wellpoint, Inc.

Projects under way or under consideration include:

  • Making the case for systems approaches in health.
  • 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.

In-person attendance at meetings is by invitation only due to room capacity limitations. All meetings are available by webcast, and information on joining the webcast is available on the meeting event page as the meeting approaches.

Past Public Meetings:

For more information, contact

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