Providers skeptical of value-based care

By Mike Miliard
11:03 AM
But still think it's the wave of the future, with IT at its core

While majorities of providers see value-based payment models becoming the status quo in healthcare, and three quarters say information technology will be critical to making them work, fewer than one-in-three say the reward is worth the risk.

[See also: Revenue cycle ripe for radical change]

Some 75 percent of providers currently participate in at least one value-based model, according to new research published by Availity, and more than 60 percent expect them become the dominant payment strategy going forward. But less than 30 percent believe they offer a good level of reward for the risk, according to the study, "Provider Attitudes Toward Value-Based Payment Models."

Based on polling of more than 500 physician practice and hospital-based professionals, the study asks for providers' real-world experience with these new models and about the hurdles standing in the way of successful shifts toward value-based care.

[See also: Value-based payment models expected to reach tipping point by 2018, study finds]

One of the biggest challenges is managing value-based models concurrent with existing fee-for-service arrangements and across numerous health plans, according to Availity. That's creating issues that range from accurate revenue forecasting to workflow integration challenges.

"The administrative complexity of administering these plans is likely to be costly. The unpredictability of the revenue stream is likely going to make administering some of these plans not worth the cost," said one respondent.

Both people and technology were key to making these new models work effectively, according to those polled. More than 80 percent cited a need for additional staff and time to manage value-based models that represent less than 20 percent of their current revenues. And the need for workflow tools and real-time access to data was named by more than 75 percent as essential for success.

"The health care revenue cycle is incredibly complicated and it's undergoing a transformation," said Russ Thomas, Availity CEO, in a press statement. "In addition to the challenges presented by rising patient financial responsibility and ongoing pressure to reduce operating costs, payment reform initiatives are driving the shift from fee-for-service to fee-for-value.

"But unless we equip providers – and health plans – with the right tools and access to the information they need, we risk further complicating an already complex and fragmented system. This study identifies key provider concerns, and the gaps and barriers that need to be addressed for these new models to scale and be successful."