Providers see importance of VBC, but lag in preparation

The vast majority of healthcare providers believe value-based care is a requirement for their future survival but only about half say they are ready for its successful adoption.

This is one of several important insights revealed in a just-completed survey by Health Data Management of IT executives at provider organizations.

In the study, only about half of respondents say they believe their organizations are technologically prepared to succeed in the new environment.

That lack of preparedness comes despite the fact that nearly three out of four respondents who participated in the study believe that the ability to effectively deliver value-based care will be either very important or extremely important to the viability of their organizations. The contrasting data points serve as a powerful reminder of the technological commitment required to adopt VBC.

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The study also highlights how far VBC has yet to advance before becoming the industry norm. Even as more contracts are shifting to value-based care approaches, some 41 percent of IT executives surveyed say their organizations are only somewhat effective in providing VBC.

The study was conducted by Health Data Management and SourceMedia Research, the research arm of HDM’s parent company. A total of 160 responses, primarily from provider organizations, were received in late 2018.

In general, respondents said their organizations realize the importance of readiness to shift to value-based care, but key technology and culture capabilities stood in the way of making an effective transition to the new care plans.

Under value-based care contracts, providers bear responsibility for improving the quality and outcomes of patients. The contracts incentivize providers to make healthcare proactive, to prevent illnesses from becoming serious, and emphasizing services that promote overall wellness, quality of care and preventive care. In theory, these actions help reduce overall care costs, enabling providers to offer better care at less cost; providers that can do so most effectively are more likely to financially benefit.

However, readiness for value-based care requires organizations to have strong IT capabilities in place, such as analytics, patient records that are readily accessible throughout an organization, and a new culture that seeks to delivery care effectively—that’s a contrast to past practices of fee-for-service contracts, which reimbursed providers on the volume of services, with no attention paid to the value of those services.

Many industry experts believe IT prowess and improved data sharing will be crucial to success with value-based care. For example, Health and Human Services Deputy Secretary Eric Hargan believes the healthcare industry will not be able to move to a system that rewards value without achieving health IT interoperability.

Speaking at the opening session of the ONC Annual Meeting in Washington in late November, Hargan said he believes that health IT interoperability is critical to the industry successfully transitioning from fee-for-service to value-based payment. “It is actually impossible to move to a future health system—the one that we need, one that pays for procedures rather than sickness—without a truly interoperable health IT system,” he added.

In the survey for Health Data Management, 37 percent of respondents said value-based care would be extremely important for their organizations, while 35 percent said it would be very important. Another 15 percent of respondents predicted it would be somewhat important for their organizations.

By contrast, 41 percent of respondents said their organization was only somewhat effective in providing value-based care; another 7 percent said their organizations were not effective in meeting the demands of VBC. By contrast, a total of 40 percent of respondents said their organizations are either very effective or extremely effective in providing value-based care.

Cost controls loom as one of the biggest challenges to succeeding in value-based care, respondents reported. Some 54 percent of them said cost controls were either very challenging or extremely challenging; another 26 percent said such controls were somewhat challenging.

Effective data sharing and usage—believed by many experts to be crucial to success with value-based care—also looms as a significant issue. A total of 52 percent of respondents said data use was either very challenging (34 percent) or extremely challenging (18 percent). Another 28 percent of respondents deemed data sharing and usage to be somewhat challenging.

From an IT perspective, poorly structured data was identified by 47 percent of respondents as either very or extremely challenging. The same percentage picked effective integration of care as either very or extremely challenging.

Patient engagement—organizations’ efforts to get patients involved in their own care—was identified as a top challenge by 44 percent of respondents, although nearly a third of respondents also said these initiatives are somewhat challenging.

However, respondents believe that their organizations’ mindsets are being realigned to value-based care priorities. Only 33 percent of respondents said culture barriers were either very or extremely challenging.

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