Value Incentives and Systems Approaches

Bringing together medicine and engineering for systems-based solutions

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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.

Activity Description

A joint NAM and National Academy of Engineering (NAE) ad hoc convening activity, under the auspices of the Leadership Consortium for a Value & Science-Driven Health System, the Value Incentives & Systems Innovation Collaborative (VISIC) seeks to build on the foundation of prior work engaged by the NAM and NAE by convening organizations and individuals actively working to design, develop, test, and evaluate innovative systems-based strategies for improving outcomes and lowering costs in health care.


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
  • Vanderbilt U
  • Virginia Mason Medical Center
  • Wellpoint, Inc.

  Federal Agencies

  • 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


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

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.

No upcoming meetings at this time.

For more information, contact Anna Cupito, Research Associate, at  



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