When it comes to social determinants of health, both payers and providers say they’re on top of the situation. However, both constituencies take a different approach, according to a new survey from Change Healthcare
According to the survey of 445 healthcare leaders nationwide, providers have the edge in terms of addressing such public health issues like vaping and the use of controlled substances. However, payers appear to have the edge in focusing on income disparity, housing and improving health literacy. They also appear to be taking value-based healthcare initiatives more seriously.
Neither payers nor providers seem particularly concerned about any healthcare policy shakeups that might occur after the 2020 elections.
Change Healthcare’s annual survey of provider and payer executives in some ways seems to echo the country’s current political schism. "In our 10 years of fielding this research, I don’t think we’ve seen healthcare industry leaders so polarized on some strategic issues," said Change Senior Vice President David Gallegos, "and so tightly aligned on others."
Where do the two sides differ?
Their positions on social determinants of health seem to reflect one of the widest splits. Providers appear to have the edge in terms of gathering information on substance abuse among patients (71.4% of provider executives versus 52.5% of payers). However, payers are much more effective at pinning down the income data of their enrollees (45.9% versus 26.5%). They also had a 10-point advantage in focusing on health literacy (39.3% vs. 29.6%), although the numbers suggest both factions did not consider it a major issue.
Value-based health initiatives are another area where there is a split. Seventy-one percent of payer executives say their organizations have an alternative payment model or full capitation in place, versus just 45% of providers. Moreover, 43% of provider executives say they derive 10% or less of their revenues from value-based models, compared to 21% of their counterparts in the payer community.
Payers and providers also have skewed – though different – views on consumerism. Seventy-three percent of payer executives believe they are best positioned to provide cost and quality data to individual healthcare consumers. Among provider executives, only 42% believed they are in the best position to provide such data.
Meanwhile, neither side seems to be particularly bothered by the outcome of the 2020 presidential election. Slightly more than a quarter of those surveyed believe there will be a continued unwinding of the Affordable Care Act. Only 20% believe there will be additional support for the ACA, and only 17% believe a public health plan option will be made available. Just 6% believe a buy-in option for Medicare will materialize, and only 3% think "Medicare for All" will become a reality.