Chasing the Value of Value-Based Payment Programs

Physicians increasingly are participating in value-based payment programs, but a new survey finds many believe the complexities and risks outweigh the rewards. Revenue cycle and claims clearinghouse vendor Availity sponsored a survey that research firm Decision Analyst conducted, selecting a random sample of physicians across the nation, with 324 practice-based physicians and 216 facility-based physicians responding.

Tough to Navigate Tough to Navigate

More than three-quarters of responding physicians participate in at least one value-based payment model in addition to fee-for-service, and more than 60 percent consider themselves somewhat knowledgeable about the value models. But only a quarter think the models make it easy to understand, track and project revenue, and four out of five need additional staff and time to manage the models.

Choosing Programs Choosing Programs

Medicare programs are the most common value-based payment models that respondents currently participate in. Specialists are more likely to choose the Medicare Quality Incentive Program and bundled payment plans, while primary care physicians favor pay-for-performance and medical home models. The most common metrics for value-based programs are care quality, patient satisfaction and prevention measures.

Big Chunk of Money Big Chunk of Money

Only about half of respondents think value-based payment models will improve population health and the patient experience, while reducing the cost of care. But more than 60 percent see the payment models--which affect about 20 percent of respondents’ revenue today--becoming dominant in the near future. The models could affect 60 percent of revenue by 2017.

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Plenty of Barriers Plenty of Barriers

The barriers to success with value-based payments are many, according to survey respondents. Most understand the importance of real-time information access and sharing to being successful. But there are gaps in data accuracy, data management and implementation assistance, and providers also struggle with care coordination and staff acceptance.

Where is the Reward? Where is the Reward?

To optimize success in value-based programs, respondents seek easier ways to document and exchange data, and sufficient funding to justify additional costs for participating. Less than one-third say the programs offer good rewards for the risk.

More Information More Information

The Availity report, “Provider Outlook on Value-Based Payment Models,”is available here.

Physicians increasingly are participating in value-based payment programs, but a new survey finds many believe the complexities and risks outweigh the rewards.

 

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