Artificial Intelligence, Value-Based Care, and Episode-Based Payment Reform in the United States: A Policy Case for Accountable Adoption

Laurina Wiley

No vgqbd_v1, SocArXiv from Center for Open Science

Abstract: Value-based care remains one of the clearest payment and delivery reforms available to the United States healthcare system. It pays for prevention, coordination, quality, and responsible use of resources rather than volume alone. Artificial intelligence can support that shift when organizations use it to identify actionable risk, make episodes of care easier to understand, improve navigation, reduce avoidable administrative work, and connect clinical decisions to measurable outcomes (Topol, 2019). This policy review supports broader use of value-based care, bundled payments, and episode-based analytics, while arguing that adoption needs careful governance. The main point is simple: artificial intelligence should not be treated as a stand-alone technology purchase. It should be used as infrastructure for accountable care. The paper links data infrastructure, risk prediction, bundled payment design, episode definitions, provider performance measurement, care coordination, economic evaluation, equity monitoring, and institutional accountability. Episode-based payment and bundled payment models are especially useful because they show the full course of care, encourage coordination across settings, and give artificial intelligence tools a practical target: forecasting cost, finding quality gaps, and prompting timely intervention.

Date: 2026-05-01
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Persistent link: https://EconPapers.repec.org/RePEc:osf:socarx:vgqbd_v1

DOI: 10.31219/osf.io/vgqbd_v1

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