The idea of value-based care appeals to dermatologists. The current reality? Not so much, says Marta J. Van Beek, M.D., M.P.H. | AAD 2026

Rewarding and incentivizing physicians to provide high quality care at a lower cost — who can object to that? The idea of value-based care is as attractive to dermatologists as it is to other physicians and healthcare professionals of all types, says Marta J. Van Beek, M.D., M.P.H. But then there is the reality.

“I think the whole idea is appealing, but there are no reasonable value-based care models out there for dermatology,” says Van Beek, a University of Iowa Health Care dermatologic surgeon and a clinical professor at the University of Iowa’s Carver College of Medicine. “Or, if anything, they make it more difficult for the patient, or they don't have a severity measure, and then you get penalized for treating a patient with severe disease. That's terrible medicine.”

Van Beek spoke at several sessions this weekend at the 2026 American Academy of Dermatology Annual Meeting in Denver, including one on CMS’ Merit-based Incentive Payment System (MIPS), the federal government’s system for measuring physician performance, which, in turn, affects Medicare payment to physicians, and another on advocacy in dermatology, with Van Beek focusing on healthcare finance, reform and DataDerm, the academy’s clinical data registry that dermatologists can use for MIPS reporting but also to track their performance for their own purposes.

Van Beek spoke to Managed Healthcare Executive (MHE) before the meeting.

During this segment of that interview, Van Beek shared her views on value-based care and dermatology.

She says CMS wanted to use MIPS as an “on ramp” to value-based care, but that “it is really fee for service with quality metrics.” MIPS was established by the Medicare Access and CHIP Reauthorization Act of 2015 and went into effect starting in 2017 as part of CMS’ Quality Payment Program (QPP).

Whatever the theoretical merits of value-based care, Van Beek says that currently there are very few appealing opportunities for dermatologists. “We don't want to participate in a quality program if we don't really think that it will help our patients,” she says.

An obstacle to participation is that the performance metrics for dermatologists don’t take into account severity, Van Beek says. “One of the problems with value-based care is if you don't have really good severity metrics or comorbidity metrics that are pertinent to that particular disease that you're looking at.” In contrast, the academy’s DataDerm system does factor in severity, she says.