Hospitals, healthcare systems inch toward value-based payments

Hospitals and healthcare systems are becoming more capable of functioning in a world of value-based payments, according to a new survey by the Healthcare Financial Management Association and Humana.

Although just 12 percent of the payments that come from commercial insurers are part of a value-based plan, the 146 senior healthcare finance executives queried for the survey believe that number will rise to 50 percent within the next three years.

The share of hospitals that say 10 percent or more of their revenue is tied to value-based programs doubled between August 2014 and last February, according to a recent survey by Kaufman Hall. In March, the Obama administration kicked off an initiative to accelerate the transition to value-based payments.

"I think any doubts about whether we are transitioning to more value-based payment and care delivery models have been dispelled," Jim Landman, HFMA's director of healthcare finance policy, said in a statement that accompanied the survey. He added that "now is the time for providers to focus on their capabilities to manage the transition, if they haven't done so already." 

Many of those surveyed say their organizations have some capabilities in such areas as chronic care management, post-discharge follow-up, business intelligence and an ability to compensate their physicians for providing value-based care. They also consider themselves highly capable in eligibility verification. However, the survey noted that a significant number of organizations--about 40 percent--lack interoperability, business intelligence and real-time data access, all key capabilities in the transition to value-based care, according to the respondents.

Some organizations may be intimidated by the transition and could be paralyzed over the enormity of the task, Healthcare Finance News reported. They may also lack the "operational, financial, accountability and reporting infrastructure" to assess their costs and remove waste, Rob Schreiner, M.D., managing director of population health for Chicago-based Huron Healthcare, told the publication.

"It's clear that hospital systems have concerns about their capabilities needed to achieve interoperability," Roy A. Beveridge, M.D., Humana's chief medical officer, said in a statement from the company. "The healthcare industry has an opportunity to help these hospitals systems chart a course toward interoperability while helping them address the expected rise of patients with chronic conditions."

To learn more:
- check out the survey 
- read the Humana statement
- here's the Healthcare Finance News article

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