Most payers, providers already shifting to value-based care

As the healthcare landscape continues to evolve, the transition from fee-for-service (FFS) to value-based reimbursement (VBR) is well underway, according to a study conducted by ORC International, commissioned by McKesson and published Wednesday at the AHIP Institute in Seattle.

The study, which looked at 464 payers and hospitals, found 90 percent of payers and 81 percent of hospitals currently implement a mix of value-based reimbursement and FFS. Moreover, the surveyed payers expect FFS to decrease from 56 percent to 32 percent in five years, while hospitals anticipate a decrease from 57 percent to 34 percent.

The data show implementation of value-based reimbursement depends on the region. For example, collaborative regions with one or two payers and hospitals as market leaders are closer to VBR, while organizations in fragmented regions are closer to FFS models. Accountable care organizations have a much closer alignment with value-based care then non-ACOs.

Sixty-four percent of payers report they are on pace with the transition to VBR, while 12 percent say they are falling behind. Meanwhile, 62 providers say they're on pace while 16 percent say they're behind on making the shift.

While the transition is necessary, 15 percent of payers and 22 percent of providers state the pay-for-performance model is extremely difficult to implement. Many cite technology impediments as a core issue, noting it's hard to standardize and analyze data, according to the results.

Further, insurers should speed up the adoption of value-based reimbursement so the entire healthcare industry systems-engineering principles that will boost efficiency of care, notes a recent report from the President's Council of Advisors on Science and Technology, FierceHealthPayer previously reported.

For more:
- here's the study (.pdf)

Suggested Articles

Welcome news to many health IT stakeholders: HHS announced Friday that it is extending the comment period for two proposed interoperability rules.

CMS took aim at increasing the use of generic drugs in ACA plans in a new rule filed Thursday evening.

Fidelity and the NBGH found large employers are expected to spend an average of $3.6 million this year on wellness programs.