Ready or not, value-based payment models gain momentum

By Matt Kuhrt

In the face of proposed changes to link U.S. Department of Health and Human Services payments to quality measures by 2018, more than half the respondents in a recent study indicated they were actively pursuing or developing capabilities around value-based payments for their practices.

The study, sponsored by Humana and conducted by the American Academy of Family Physicians, showed one in three physicians already pursuing value-based payment opportunities.

Despite the growing interest, concerns remain. In particular, study respondents identified the amount of time they would need to commit to implementing the models as a top problem. Other major barriers to implementation cited in the survey included the following:

  • The need to invest in updated or new health information technology
  • Insufficient administrative resources to deal with data reports, validation and utilization
  • Concerns about the predictability of the revenue stream and the complexity of the financial risks involved

The results also suggest a good deal of confusion remains among physicians regarding the details surrounding value-based payment models. Even among those already participating in value-based systems, one in three doctors was unaware of how payments were distributed within their practices.

It may not be surprising, then, that widespread skepticism prevails among physicians that these models will actually improve patient care, with 59 percent indicating they believed they would increase physician work without benefiting patients at all.

At its root, the challenge lies in defining "value" within the context of new payment models, Reid Blackwelder, M.D., immediate past president of the American Academy of Family Physicians told FiercePracticeManagement in a recent interview. Until it's clear how the Centers for Medicare & Medicaid Services will measure quality, it's difficult to gauge how the shift from fee-for-service models will actually look.

According to the physicians surveyed, the areas that would be most valuable to them included practice sustainability, clinical outcomes, physician and staff morale, coordination of patient care and cost savings for the practice.

To learn more:
- read the study
- read the survey results announcement