The future of value-based care initiatives is now in doubt as a result of the surprising victory of President-elect Donald Trump, and with Republicans retaining control of both the House and the Senate in 2016 elections.

Given that they now control the legislative process, Republicans may act on promises to repeal the Affordable Care Act. Many value-based care initiatives came into being as a result of the ACA, so it’s unclear which, if any, of the nascent efforts to study new reimbursement mechanisms will survive any efforts to scale back the 6-year-old ACA.

In particular, Republicans have formally expressed concern about the way in which demonstration projects of untested value-based care approaches have been implemented by federal agencies, saying they don’t take into account providers’ practice and offer no safeguards to protect providers from financial penalties.

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