29% of Doctors Have Tools Needed for Value-Based Care Payments
Only 29 percent of polled physicians stated that they have the tools necessary to function effectively in the world of value-based care payments.
By - While value-based care payments are making headway across the country, there are still barriers that stand in the way of payers and providers fully embracing these alternative payment models. A report from Quest Diagnostics and Inovalon found that complicated quality metrics and physicians lacking access to patient data are two major challenges to adoption of value-based care payments, according to a company press release.
Additionally, the study discovered that health plan executives and physicians see the barriers to value-based care payments and their importance on completely opposite planes. Only through greater collaboration between payers and providers could value-based care be fully embraced and executed across the healthcare industry.
The results of the survey show that only 54 percent of polled physicians are aware which quality measures actually apply to their patient base under value-based care models, which shows that the complexity of these quality performance benchmarks may be slowing down adoption of value-based care payments.
While the majority of those polled stated that having complete access to patients’ medical records is very important, as many as 65 percent stated that they did not have access to all of the medical information they need to treat their patients in a quality-based environment.
The barriers associated with obtaining full access to patients’ medical records include specialists and other doctors who’ve seen a patient but do not share health information across electronic health records (EHR), the lack of interoperability between medical devices and EHRs, and the inability to integrate patient data into their current workflow.
Additionally, new technologies and tools are needed among doctors to achieve success in a value-based care environment. Only 29 percent of polled physicians stated that they have the tools necessary to function effectively in the world of value-based care payments.
In addition, the report found some disagreement between payers and providers regarding whether or not pay-for-performance models should be adopted across the healthcare industry. While 57 percent of health plan executives support implementing value-based care reimbursement within the US healthcare system instead of fee-for-service, only 33 percent of doctors feel the same way.
“This study shows that physicians and health plan executives differ in their perceptions of how effectively the nation's healthcare system is progressing toward value-based care,” Harvey M. Kaufman, M.D., Senior Medical Director at Quest Diagnostics, stated in the press release.
“It also reveals that complexity and incomplete access to patient information may be greater obstacles to adoption than previously realized. We hope the study's findings spark greater collaboration by providers and health plans and dialogue about new solutions to improve quality outcomes and reduce overall costs.”
Payers and providers will need to keep collaborating to reach a compromise when it comes to healthcare reimbursement. Payers would be wise to assist providers in obtaining access to patient records and integrating new technologies that would ensure success in a world of value-based care.
A report from Chilmark Research shows that moving to value-based care payments will require a completely different approach than traditional payment models, a company press release stated.
The report called Evolution to Total Active Risk: New Tools and Strategies to Deliver on Value-Based Care discusses the need to target data specifically a patient’s Total Active Risk profile. This encompasses an important aspect of population health management as well as care management.
Since value-based care goes hand-in-hand with ensuring better health outcomes, it is important to target risk profiles since these metrics “account for 10 percent of a patient's overall health outcomes,” the news release states.
“Current risk models were largely developed for actuarial purposes. We now know claims and clinical datasets are not enough to effectively predict true risk for all high utilizers, and it is essential for future business success to incorporate additional measures to accurately manage the need for current and future services,” Jody Ranck, lead author of the report, said in a public statement.
“Currently there are only a handful of HCOs [healthcare organizations] and vendors tackling this problem, and those that do it well will have a significant competitive advantage in the coming years.”
Incorporating these metrics will give a broader data set to providers and potentially allow them to tap into patient engagement. By finding a stronger method for engaging patients, doctors will be able to match their consumer base with the resources and interventions they need for better outcomes.
As the healthcare industry continues to evolve toward value-based care, payers will need to work directly with providers to ensure alternative payment models are realistic within their care delivery system. Boosting interoperability, data sharing, and patient engagement will be key for driving the medical field toward reaching quality metrics and better health outcomes.
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