Only One-Third of Physicians Approve of Value-Based Care Models

June 15, 2016 - Value-based care models represent the future of patient care and reimbursement structures for most healthcare stakeholders, but some providers may not have such positive views on new payment and care arrangements.

If a recent survey is any indication, healthcare stakeholders may need to collaborate to improve value-based care models to better support physician workflows and patient data sharing.

A Quest Diagnostics and Inovalon survey found that only one third of physicians believed the healthcare system should transition to value-based care, whereas 57 percent of health plan executives approved of the transition.

“This study shows that physicians and health plan executives differ in their perceptions of how effectively the nation's healthcare system is progressing toward value-based care,” said Harvey M. Kaufman, MD, Quest Diagnostic’s Senior Medical Director. “We hope the study's findings spark greater collaboration by providers and health plans and dialogue about new solutions to improve quality outcomes and reduce overall costs.”

More physicians may disagree with value-based care models because they have experienced more challenges implementing the quality-based structure.

While 75 percent of respondents stated that quality measures were useful in improving care quality, three quarters of participants reported that measures were too complicated, which made it harder for physicians to meet quality goals.

More surprisingly, only half of the participants agreed that physicians think about value-based care measures when meeting with patients. Moreover, 47 percent said that physicians clearly know which quality measures apply to individual patients under relevant value-based care models.

Value-based care models could benefit healthcare organizations more in terms of financial incentives and advancing quality care, if providers understood what care management resources patients are eligible for, reported 88 percent of respondents.

Although the majority of participants agreed that quality measures were too complex, health plan executives usually expressed more confidence in a provider’s ability to understand and use quality measures. Researchers suggested that health plan executives may not be fully aware of the true complexity of value-based care models at the point of care.

Another major challenge with value-based care was access to patient data, according to the survey. Without more complete healthcare information, providers have found it difficult to treat patients under value-based care models.

Sixty-five percent of physicians noted that they do not have access to all the healthcare information they need about their patients, even though 87 percent of respondents reported that complete access to a patient’s medical record is very or extremely important.

This has left about two thirds of physicians unsatisfied with access to data within their established healthcare workflows.

The top limitation to patient data accessibility was that other physicians that treat the patient do not share healthcare information across EHR systems and other channels, explained 78 percent of participants. A close second was a lack of interoperability (74 percent), followed by restrictions of current physician workflows that prevent integration of patient data (37 percent).

Healthcare interoperability and data sharing may need to become more of a priority for implementing value-based care models, especially since 90 percent of respondents agreed that limited access to patient data at the point of care can hinder quality treatment.

In addition to data sharing issues, most physicians reported that their workflows lacked the necessary tools to implement value-based care models. Sixty-four percent of respondents said that providers do not have the tools that are needed to participate in successful value-based care models.

When asked if there was a tool that existed within the physician’s current workflow that promoted quality and value-based care, almost half of the participants stated no or they were uncertain.

Even though EHR implementation has been a significant aspect of developing value-based care models, many healthcare stakeholders are uncertain about its true value with new payment models. Among the participants who responded yes, only one third identified an EHR system as being that tool.

However, about 85 percent of physicians were open to using a tool that provides “on-demand patient-specific data” to help pinpoint gaps in quality, risk and utilization, and medical history insight within the physician workflow.

Additionally, a lack of enthusiasm as well as inadequate tools could be contributing to the delay in value-based care implementation. Another recent survey from Health Catalyst reported that three quarters of hospitals anticipate meeting the government’s goal of connecting 50 percent of Medicare payments to a value-based model within two years.

With so few providers feeling confident about the industry’s transition to value-based care, the healthcare community may need to reevaluate its strategies for applying alternative payment models.

Dig Deeper:

• 4 Value-Based Care Models Demanding New Long-Term Focus

• Physicians List Top 5 Value-Based Payment Success Factors