Value-based reimbursement programs with quality of care and cost-reduction targets can result in benefits both for payers, providers and for the nation as a whole, according to FTI Consulting, but it hasn't been easy to get payers and physicians on board.
An FTI Consulting payer-provider survey conducted in April and June found 41 percent of physicians not currently in a value-based relationship say their biggest obstacle to entering into one is their distrust of payers.
Additional findings from the FTI survey include:
- Of the payers surveyed, 80 percent said value-based arrangements incentivized by the Patient Protection and Affordable Care Act are "very important" to their strategic objectives.
- Of the physicians surveyed, 92 percent said value-based arrangements are either "somewhat important" or "very important."
- Traditional fee-for-service contracts still dominate the healthcare industry. More than half (55 percent) of payers say many of their commercial contracts remain fee-for-service, and only 10 percent report that they no longer have any fee-for-service arrangements.
- Fifteen percent of polled physicians say they are "only interested" in the fee-for-service reimbursement model.
- Nearly four-fifths of payers currently are building accountable care organization-type arrangements in which payers and physicians share in the savings they achieve for the Medicare program.
- Payers believe that only 5 percent of providers are willing to accept the downside risks necessary for value-based models to work.
- In reality, 16 percent of physicians say they are willing to accept risk, and almost half (49 percent) are mostly interested in upside risk-sharing models.
- Half of physicians report that their organization has implemented new technology or software to support population health management and value-based reimbursement, 32 percent have not and 18 percent either don't know or are unsure.
- Eighty-four percent of payers report they are implementing healthcare IT and population health management tools to meet quality and cost-reduction targets in value-based arrangements. Some tools include EHR platforms, portals for physicians and patients, analytics and customer relationship management tools.
- About one-third (34 percent) of physicians say that are "not very often" approached by payers for value-based arrangements.
- FTI Consulting interviewed 20 U.S. payers and surveyed 251 physicians specializing in general practice, internal medicine and family medicine.