When we know something works, we ought to do it. But what if we think we know what works, or that it could work if we did enough of it?

This is the paradox of testing and scaling that has been value-based care for the past decade. Recent reports highlight the growing importance to providers of payer alignment to support implementation of value-based care and population health.

Coral did not create this witty title. Another consulting firm wrote a blog with a similar title when the Quality Payment Program (QPP) first emerged with the concept of Qualifying Participants (QPs) in 2017. The idea behind QPP was to give special status to those entities moving into downside risk and taking accountability for the cost and health outcomes of their patient population. By virtue of being a QP, participants were exempt from the Merit Based Incentive System (MIPs) - a comprehensive quality reporting framework that determined the way all other physicians were paid. This was the plan for continuing to encourage the move away from fee-for-service (FFS) and towards value. And every year, the Physician Fee Schedule (PFS) updates QPP including what it takes to be a QP and the requirements for MIPs.