What we're working on

Value-based purchasing (VBP) is a strategy the Health Care Authority (HCA) is using to improve the quality and value of health care services a person receives. HCA envisions a Washington in which health care is patient-centered, team-based, high-quality, equitable, and affordable.

Strategic goals

2016-2022: The 90 percent goal

In 2016, HCA set an ambitious goal of driving 90 percent of state-financed health care payments into VBP contracts by the end of 2021. HCA also set annual interim targets to help us get to 90 percent. HCA tracks progress toward this goal with annual Paying for Value surveys for both payers and providers.

Progress towards 90 percent adoption goal. See long description.

Chart long description: Progress towards HCA’s 90 percent value-based purchasing (VBP) adoption goal

This bar chart from the VBP roadmap shows the goal percentage and the actual percentage of state-financed health care spending in VBP arrangements.

  • In 2016, the goal was 20 percent, and the actual was 30 percent.
  • In 2017, the goal was 30 percent, and the actual was 43 percent.
  • In 2018, the goal was 50 percent, and the actual was 54 percent.
  • In 2019, the goal was 75 percent, and the actual was 66 percent.
  • In 2020, the goal was 85 percent, and the actual was 77 percent.
  • In 2021, the overall agency goal was 90 percent. The goal for managed care organizations (MCOs) was adjusted down to 85 percent due to COVID-19. The actual was 83 percent.

2023-2027: Advance VBP adoption and advance health equity

In 2021 and 2022, HCA developed and finalized a set of new strategic goals for VBP in 2023 to 2027. These will be integrated into all HCA purchasing activities.

Goal 1: Continue promoting and advancing VBP

HCA will continue striving to reach 90 percent of state-financed health care in VBP contracts, including in the Medicaid fee-for-service program. In addition, we will work to drive 50 percent of state-financed health care into more advanced VBP arrangements in which providers take on some financial risk. At the same time, HCA will strive for better visibility into state-financed VBP by emphasizing oversight, accountability, monitoring, and evaluation.

Goal 2: Leverage our purchasing power to improve overall health and health equity in Washington

As the state’s largest purchaser, it is our responsibility to use our power to advance equity and reduce disparities across the health system. As part of this goal, HCA is working to identify key health equity priorities from both data-driven and community-driven perspectives. We will then leverage VBP initiatives to support these goals and hold plans and providers accountable for the quality and equity of care in our state.


Kahlie Dufresne
Special assistant for health policy and programs