Slideshow Chasing the Value of Value-Based Payment Programs

  • May 20 2014, 4:55pm EDT
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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.

<B>Tough to Navigate</B>

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.

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<B>Choosing Programs</B>

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.

<B>Big Chunk of Money</B>

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.

<B>Plenty of Barriers</B>

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.

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<B>Where is the Reward?</B>

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.

<B>More Information</B>

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