Survey Finds Stakeholder Disconnects on Emerging Payment Models

A survey conducted during the first half of 2012 finds large numbers of providers, insurers and pharmaceutical executives acknowledge major changes coming in health care payment systems, but believe their current business models are “somewhat” sustainable for five more years.


A survey conducted during the first half of 2012 finds large numbers of providers, insurers and pharmaceutical executives acknowledge major changes coming in health care payment systems, but believe their current business models are “somewhat” sustainable for five more years.

The numbers of respondents anticipating up to a five-year cushion are 40 percent of providers, 53 percent of insurers and 43 percent of pharmaceutical firms, according to consultancy KPMG. It conducted the survey between January and June 2012, with responses from 104 providers, 51 health plans and 54 pharmaceutical firms.

The survey underscores a disconnect of stakeholders really understanding the changes that are coming, according to the consultancy. While adhering to a somewhat sustainable current model, 65 percent of provider and 41 percent of payer respondents do expect major business model changes in the next five years, with 63 percent of pharmaceutical respondents expecting moderate changes.

“The findings really underscore the key question of whether or not any organization can be both committed to non-volume-based care economics while at the same time working to sustain a volume-driven reimbursement status quo,” says Ed Giniat, national sector leader of KMPG’s healthcare and pharmaceuticals unit.

Half of provider respondents said it was “extremely” important to maintain or increase commercial reimbursements rates, versus Medicare and Medicaid, and 80 percent said they have the market position to do so.

A Web seminar on the survey findings is available here.

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