Dive Brief:
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In a new survey, 62% of healthcare organizations said they’re prepared to change to a new payment system, with 54% saying they’re ready or almost ready for value-based care delivery changes.
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The 2018 HealthLeaders Media Value-Based Readiness Survey found momentum for a move to value-based care. Nearly one-quarter of respondents said they are currently in value-based programs and nearly half (46%) expect to move to value-based programs in the next three years.
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However, the survey also reported that half of the respondents acknowledged that their value-based infrastructure is “very weak or somewhat weak.”
Dive Insight:
John Adams, CEO of Global Healthcare Alliance, sponsor of the survey, said hurdles remain for healthcare organizations transitioning to value-based care. However, Adams said that with the right team, operations and technology, “value-based programs are not only possible but also highly sustainable.”
This is just the latest report to find healthcare officials are interested in value-based care. However, actually moving from fee-for-service to a value-based system isn't as easy as flipping a switch, especially when providers have to work with other organizations and providers outside of their system.
A recent Change Healthcare survey of 120 payers found they’re moving to a value-based system faster than expected. The study also found payers need time to implement the payment models. More than one-third of respondents said they need at least one year.
The new survey found that healthcare organizations have developed financial competencies to prepare for value-based care. They’re doing this by implementing value-based performance metrics and aligning employed physicians/providers. However, nearly one-quarter said that developing a provider-sponsored health plan is challenging.
“The skill sets and staff necessary to be successful in this area are typically outside the mainstream of the provider domain,” according to the report.
Also, aligning independent physicians/providers and developing risk-based relationships with providers outside the organizations are difficult, according to survey respondents.
Concerning what kinds of value-based system interests them, respondents chose fee-for-service with upside, such as performance awards, as the top payment model (63%). That was followed by bundled payments (50%) and shared risk, such as an accountable care organization (49%). On the other end, only 7% said they’re interested in full capitation and 11% said the same about partial capitation.
Employers are also interested in value-based care. The National Alliance of Healthcare Purchaser Coalitions, a nonprofit network of business coalitions that includes more than 12,000 purchasers covering 45 million Americans, announced this week that it’s partnering with Remedy Partners to create bundled payment programs.
There’s growing momentum for value-based care, but questions remain about its effectiveness in reducing costs. A recent Healthcare Financial Management Association study found that these models had no impact on cost or clinical outcome changes in their early years.
The HFMA study said the reason for the poor results was connected to a limited number of value-based models in many markets, lacking financial incentives to manage total cost of care, healthcare organizations preferring an incremental move to value-based care and employer reluctance to change benefit design.
The HFMA study authors said one way to strengthen value-based care initiatives is adopting "population-based models that represent sufficient revenue to incentivize providers to actively manage the total cost of care, while acknowledging that other models may turn out to be more appropriate in some circumstances."