A majority of states are now buying into value-based care

Only seven states have little to no activity around value-based payment models, a study by Change Healthcare found.
By Beth Jones Sanborn
01:03 PM
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Alternative payments models and value-based care have definitely taken root across the United States, according to a new national study commissioned by Change Healthcare. The study found that more than 40 states are pursuing value-based payment programs, with 15 multi-payer initiatives across those states.

The study was based on publicly available information compiled from May through October 2017 gleaned from state resources, federal government resources, contractors and research reports from healthcare industry analysts, media, think tanks, public policy institutes and research institutes, Change said.

In addition to pursuing value-based programs, 23 states have developed value-based targets or mandates that payers and providers agreed to achieve, 17 have or are considering adoption of ACOs or ACO-like entities, and 12 have or are considering episodes of care programs. 

In fact, only 7 states have little to no activity around value-based payment models, the study said.

"To scale these complex payment arrangements, payers and providers will need to rely even more on their healthcare information partners to help them model, automate, and analyze their programs to ensure cost savings, appropriate care, and fast, accurate payment,” said Carolyn Wukitch, senior vice president a general manager, Network and Financial Management, Change Healthcare.

What’s more, the study stressed that value-based care is driving investment in consumer engagement strategies and technologies as consumers become more responsible for out-of-pocket debt and increasingly expect a more retail-like experience from their healthcare providers.

Providers, for their part, are struggling to gain a better understanding of the new healthcare consumer and learn more about their behavior. So a separate part of the study sought answers on the state of consumer engagement. Change commissioned ORC International, a global healthcare research firm, who surveyed executives from 251 providers and 89 payers on how they are “approaching and investing in their consumer-centric goals.”

It also used a U.S. census-weighted sample of 771 consumers who were polled to learn how their consumer experience with their providers and health plans had changed over the previous two years, what technologies are being utilized to engage with payers and providers, which technologies they prefer, and which they consider most important.

The survey found that investment in consumer engagement was a top priority for 80 percent of payers and 72 percent of providers surveyed, with value-based care being the biggest driver of that trend. Competitive pressures and consumer demand for a more retail-like experience were also contributing factors. 

The survey also showed payers and providers are channeling roughly a quarter to a third of healthcare IT investment dollars toward consumer engagement.

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com