There is broad consensus that physician and other provider payment methods need to evolve from rewarding “volume” to promoting “value.” But what that means exactly, and what will be the recipe for success, remains somewhat elusive. The Health Care Payment Learning and Action Network’s (LAN) Framework establishes a logical categorization of payment models that will help monitor the progress of payment reform. Yet, the Framework assumes that value proceed along the same continuum. The brief argues that the specific operational designs adopted, the organizational culture and other circumstances in which the payment method is implemented and other practical concerns contribute importantly to whether any payment method provides more or less value, questioning the usefulness of movement along the LAN Framework’s continuum as the basis for determining progress in payment reform.

A related blog post is available on Health Affairs at https://doi.org/10.1377/forefront.20160919.056648