About the Study : In this cohort study, participation in mandatory value-based payment programs was associated with increased hospital administrative costs. These findings suggest that policymakers should consider administrative burden when designing and evaluating payment reforms to ensure that anticipated improvements in cost, quality, and access are not offset by increased complexity.
Corresponding Author : Zehui Zhou, MPH, Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 S Main St, Providence, RI 02903 ( zehui_zhou@brown.edu ).
10.1001/jamahealthforum.2026.2503
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