Value-based payment models: Doctors describe the disconnect between theory and practice (Medical Economics)

Despite CMS’s goal for full Medicare and most Medicaid participation in accountable care by 2030, less than half of primary care physicians are joining value-based payment models. Financial constraints, workforce shortages, and excessive documentation remain significant barriers. Fee-for-service still dominates, and small practices lack resources to transition. Physicians support the concept but struggle with implementation, citing unpredictable reimbursement, limited institutional support, and overwhelming quality metrics.