National Survey Results Align with HAP Findings about Growth in Value-based Payments, Key Challenges
February 26, 2018
Two new reports based on surveys of health care leaders nationwide align with findings from HAP’s recent survey about the use of value-based payments in Pennsylvania. Although reported rates of adoption vary, respondents from all three surveys believe that value-based payments will continue to grow rapidly in both private and public payor markets.
Health Care and Insurance Executives Predict Risk-sharing Will Prove Most Effective
Fielded during late 2017, Change Healthcare’s 8th Annual Industry Pulse Survey asked health care leaders, including executives at leading national and regional payors, about:
- The alternative payment models currently used by their organizations
- Which models would be most effective during the next three years
Recently published survey results show that:
- Risk-sharing arrangements top the list: Nearly half (45.6%) of respondents already use arrangements such as accountable care organizations. More than one in five (23.8%) predict these will be the most effective alternative models during the next three years.
- Pay-for-performance is next: 43 percent of respondents use this arrangements; 18.4 percent predict optimal efficacy by 2020
- Other top responses: These included full capitation and partial capitation
- Social determinants of health a priority: More than 80 percent of respondents say they are promoting value-based health care by addressing the social needs of their members
This online survey was commissioned by software analytics provider Change Healthcare and the HealthCare Executive Group. The national research sample draws from the Change Healthcare customer base of more than 2,000 senior health care leaders (nearly 80% are vice presidents or C-suite), including leading national and regional payors.
HFMA Survey Shows Value-based Payment Adoption and ROI Have Improved
During September 2017, the Healthcare Financial Management Association (HFMA) surveyed 117 senior financial executives, including those at hospitals, about value-based payment readiness.
Based on survey responses, HFMA reports that:
- Health plans’ use of value-based payment models doubled from 12 percent during 2015, to 24 percent during 2017
- Nearly three-quarters of respondents’ organizations achieved positive financial results, including return on investment, from value-based payment programs
- 26 percent of negotiated government plans, such as Medicare Advantage and managed Medicaid, were value based, compared to lower rates for commercial plans (24%), traditional Medicare (21%), and non-managed Medicaid plans (14%)
The HFMA report was sponsored by Humana, Inc.
HAP Survey Predicts Alternate Payment Models Will Account for 28% of Hospital Payments by 2020
Results from HAP’s survey of Pennsylvania hospital finance leaders shows that they expect alternative payment models and population-based payments to account for progressively more of hospitals’ revenue.
Payments from these models are expected to grow from 6 percent of all payments during 2017, to 28 percent during 2020.
HAP, HFMA Survey Results Agree on Key Barriers to Value-based Payment Adoption
The HAP and HFMA surveys identify the key barriers to the “value, not volume” transformation as:
- Lack of resources
- Inconsistencies among payors
- Lack of physician alignment and support
HFMA survey findings validate HAP’s advocacy priorities, including efforts to:
- Align value-based performance measures among state, federal, and commercial payors
- Improve providers’ access to data and information that will allow providers to assume risk and manage population health
- Partner with providers, payors, and the Centers for Medicare & Medicaid Services to identify funding to support value-based payment implementation and reduce short-term risks
- Develop alternative value-based programs for rural health providers
- Support expansion of telehealth services
- Determine and implement opportunities to further integrate physical and behavioral health
- Leverage existing population health initiatives to support commonwealth goals
For additional information about the HAP’s value-based payment efforts, please contact Kate Slatt, HAP’s senior director, innovative payment and care delivery.