- More than half of family physicians are participating in value-based payment models, and half of those surveyed believe value-based payments will lead to greater collaboration between primary care physicians and specialists.
- The 2017 Value-Based Payment Study released by the American Academy of Family Physicians (AAFP) and Humana found that value-based payments “based on achieving quality and/or outcome measures” have more than doubled since the last study two years ago. The study found 37% of value-based payments are based on quality and/or outcomes compared to 18% two years ago.
- Care coordination is also more common than two years ago. Thirty-two percent of physicians surveyed said they provide “ongoing care management/coordination” to high-risk patients. That’s an increase from 23% in 2015.
As part of value-based models, more physicians are hiring care management and care coordinators. One-third of surveyed physicians said they hired coordinators two years ago. That number increased to 43% this year.
One of the reasons for the greater use of value-based payments is improved health IT. The survey found that 54% of family physicians said it’s updating or adding health IT infrastructure for data management and analysis to participate in value-based payments.
Though value-based payments and care coordination have caught on, family physicians still face the same barriers as the last survey from 2015:
- Lack of staff time
- Lack of transparency between payers and providers
- Lack of standardization of performance measures
- Lack of uniform performance reports from payers
Another increasing problem is that physicians believe it is harder to achieve quality expectations to meet value-based payment models. Only 8% of family physicians in this year's survey said quality expectations are “easy,” which is down from 13% two years ago.
Roy Beveridge, Humana’s chief medical officer, said the study shows more family physicians have implemented value-based payments. But physicians are still concerned that it’s not influencing their patients’ health, helping staff morale or improving the practices’ performance. AAFP President Michael Munger, said family physicians are making changes and investments to transition to value-based care, but issues involving administrative burdens and lack of data transparency and standardization for reporting requirements remain.
These barriers are not a surprise. In addition to the issues mentioned, physicians in recent years have also complained about electronic health record overload and concerns about burnout as reasons why they remain concerned about value-based payments.
Of the physicians who said they have not integrated value-based payments in the study, one-third of them said they were “too busy and overwhelmed to think ahead.” That’s 12% higher than two years ago, which shows the additional burdens that doctors are feeling today. Also, nearly one-fifth of physicians said that value-based payments are “too risky.”
Most experts agree that value-based care and payments are the future. Private payers and CMS both are working on projects to expand value-based payments, so they’re not going away. However, if payers want to gain physician buy-in, they will need to figure out ways to lessen the administrative burden and allay physician fears about risk.