Objective: Brazilian National Agency for private healthcare system (ANS) regulates private healthcare system in Brazil. ANS, since 2019, is running the Porter’s based pilot value-based new payment models project. This study aims to analyze the process of construction of key indicators (patient-centric) to implement VHBC projects.

Methodology: We have interviewed managers of private healthcare plans participating in the ANS’ Value-Based Payment Models (13 projects). Data was collected through semi-structured interviews during 2021. 12 managers were invited to participate in the interview, 8 accepted. The key questions were: How was the process of developing, implementing and monitoring patient-centered or cost indicators? Are there other indicators besides the one mentioned that are included in the remuneration model contract?" For data analysis, Bardin's content analysis was chosen. Data validation was performed using the debriefings technique.

Results: The answers identified that the indicators were subdivided into two areas: administrative processes (73%) and care (27%). The first was related to procedures and hospitalizations (41%), loyalty (26%), and cost (19%). The second 40% refer to quality indicators, and 40% to care journey. The challenges found during the project implementation were related to data collection (43%) and data error (29%). The third element refers to the need for the measurement process, where 75% is related to the need for flexibility for changes, and 25% in the need to measure results, pointing that some sort of certification would be needed. Finally, about the results, 67% refer to the perceived results, costs less for health plans, and 33% to the positive results presented.

Conclusion: The study suggests that administrative processes rather than care delivery key indicators are being used in the value-based payment model projects in Brazilian private healthcare system. There are no Patient-Reported Outcome Measure (PROMs) or comparability between providers.