7 Insights on progress toward value-based care

Published
  • June 06 2017, 4:00am EDT

7 insights on achieving progress toward value-based care

A survey of 302 primary care physicians with hospital affiliations and 150 health plan executives examines progress that must still be realized to achieve value-based care. These include achieving better alignment between providers and payers and improvements in electronic health records to bridge critical gaps. Some widely differing views exist between providers and insurers on common issues. Quest Diagnostics, a national laboratory chain and IT vendor, and cloud hosting vendor Inovalon, commissioned the April survey conducted by Regina Corso Consulting.

1. ACA repeal and replace won’t stop value-based care

Efforts in Washington to repeal and replace the Affordable Care Act may cast doubt on some facets of healthcare, but the transition to value-based care is not one of them, more than 80 percent of surveyed physicians and insurers believe. As a result, IT initiatives should move forward in anticipation of the eventual transition to value-based care.

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2. Fee-for-service still dominates

Despite agreement among leading stakeholders that value-based care models can improve healthcare, most surveyed physicians and insurers continue to believe that the healthcare system is fundamentally fee-for-service. Physicians in practice for at least two decades are more likely to believe fee-for-service dominates the industry than those in practice for fewer than 20 years.

3. More work to be done to align health plans and providers

Some 70 percent of surveyed insurance executives said progress has been made to better align health plans and providers in healthcare, but less than half of surveyed physicians agreed. Despite this divide, most providers and insurers agree that more than ever there is a need for alignment between payers and providers to achieve value-based care.

4. Tools are still needed to advance value-based care

One of the most striking findings is around the misalignment between perceptions of the availability of tools to advance value-based care. Some 53 percent of insurer respondents say physicians have the tools they need to succeed in a value-based system, while only 43 percent of physicians agreed. In a similar survey last year, however, the gap was 15 percentage points, suggesting progress toward alignment. And in 2016, only 29 percent of physicians said they had the tools they needed, reflecting a 14 percentage point increase in one year.

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5. EHRs are not closing all gaps

While 75 percent of health plan executives said EHRs have everything physicians need, only 54 percent of the doctors agreed. Additionally, 70 percent of the doctors said they do not see a clear link between their EHRs and better patient outcomes. Some 65 percent of physicians also indicated that if they could get one key insight at the point of care it would be information related to performance or quality measures that apply to their individual patients.

6. Extending EHRs could unleash value

Physicians continue to invest in EHRs and, despite doubts about their value, are open to their potential. More than 70 percent are willing to spend more time using technology if their EHRs could yield insights unique to their patients, and 85 percent say access to quality and performance measures specific to their patients is key to achieving value-based care. These findings suggest EHRs could provide an avenue for physicians to seek out information to aid quality and performance measurement reporting. Imbuing current EHR offerings with this type of data could potentially extend their value, according to Quest Diagnostics and Inovalon.

7. Co-investment in HIT may be the key

Some 85 percent of surveyed insurance executives believe a co-investment in health IT by health plans and providers would accelerate value-based care adoption. This finding supports other research showing health plans experience greater benefits from the implementation of IT, such as EHRs, than the providers that implement them. Perhaps health plan leaders are mindful of the significant HIT investment of providers and the potential for co-investment to help surmount this challenge.

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In conclusion

The survey suggests that differing perceptions of physicians and health plan executives about the use of information technologies to advance value-based care are part of the problem. But it also suggests both sides want to work together to foster adoption of value-based care. Through better alignment and more co-investment of time and resources, there is potential to speed adoption of a health system centered on the value patients receive, not on the quantity of services delivered.